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Prognostic factors for hepatocellular carcinoma recurrence: experience with 83 liver transplantation patients.

Abstract：

INTRODUCTION:Orthotopic liver transplantation (OLT) is a rational therapeutic option for early-stage hepatocellular carcinoma (HCC) providing a potential cure and improving survival. METHODS:This retrospective study of a longitudinal cohort used an electronic database collected prospectively from September 1997 to May 2010. The variables were gender, age (years), and alpha-fetoprotein (AFP) level (ng/mL). In explanted livers we observed: microvascular or macrovascular invasion, number of nodules and their largest size, Edmondson-Steiner histological differentiation, incidental tumor transarterial chemoembolization (TACE), Milan criteria, and previous down-staging. RESULTS:Five of 83 (6.0%) subjects including 68 (82%) males with a mean time to diagnosis of 9 months experienced tumor relapses. Mean patient age at HCC recurrence was 55.3 years for male and 44.6 years for female subjects. Vascular invasion was detected in 17/83 (20.5%) subjects, namely 2% of macrovascular invasion, and 52.5% with expanded Milan criteria due to an increased number and size of nodules in the explanted livers. An incidental tumor was observed in 29.5% of cases. Preoperative TACE treatment was performed in 13 (15.6%) patients. None of the patients who had a HCC recurrence had undergone TACE. AFP level at the time of recurrence was around 1,900 ng/mL. The predictive factor for mortality was nodule size (P=.04; hazard ratio=0.0269; confidence interval [CI], 95% 0.0094-0.299). CONCLUSION:Patients with relapses showed the worst survival and tumor size was a predictive factor for recurrence.

journal_name

Transplant Proc

journal_title

Transplantation proceedings

authors

Ataide EC,Boin IF,Almeida JR,Sevá-Pereira T,Stucchi RS,Cardoso AR,Caruy CA,Escanhoela CA

doi

10.1016/j.transproceed.2011.02.032

subject

Has Abstract

pub_date

2011-05-01 00:00:00

pages

1362-4

issue

4

eissn

0041-1345

issn

1873-2623

pii

S0041-1345(11)00338-1

journal_volume

43

pub_type

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