Publication Name	World Journal of Gastrointestinal Oncology
Manuscript ID	118170
Country	India

Category	Gastroenterology & Hepatology
Manuscript Type	Letter to the Editor
Article Title	Toward biology-driven transplant oncology: The role of PIVKA-II in alpha-fetoprotein-normal hepatocellular carcinoma
Manuscript Source	Invited Manuscript
All Author List	Sagar Raut and Pradeep Naik E
Funding Agency and Grant Number
Corresponding Author	Sagar Raut, Assistant Professor, MD, Department of Radiotherapy and Oncology, PGIMER Satellite Centre, Patiala Road, Sangrur 148001, India. snraut161@gmail.com
Key Words	Des-gamma-carboxy prothrombin; Hepatocellular cancer; Alpha-fetoprotein; Hepatic transplantation; Organ transplantation; Milan criteria
Core Tip	Hepatocellular carcinoma with normal alpha-fetoprotein (AFP) levels is a frequently missed when transplantation selection relies heavily on morphological criteria and AFP levels. Emerging evidence identified PIVKA-II as a robust marker of aggressive tumor biology in this subgroup. PIVKA-II successfully categorized high-risk disease despite favorable imaging and normal AFP levels. Integration of PIVKA-II with existing selection frameworks will enable a shift toward biology-driven transplant oncology and reduce post-transplant recurrence.
Citation	Raut S, Naik EP. Toward biology-driven transplant oncology: The role of PIVKA-II in alpha-fetoprotein-normal hepatocellular carcinoma. World J Gastrointest Oncol 2026; In press

Received	2025-12-26 01:39
Peer-Review Started	2025-12-26 01:39
First Decision by Editorial Office Director	2026-01-14 02:53
Return for Revision	2026-01-14 02:53
Revised	2026-01-28 06:43
Publication Fee Transferred
Second Decision by Editor	2026-02-04 02:52
Second Decision by Editor-in-Chief
Final Decision by Editorial Office Director	2026-02-04 06:24
Articles in Press	2026-02-04 06:24
Edit the Manuscript by Language Editor
Typeset the Manuscript

ISSN	1948-5204 (online)
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