Outcome and Risk Factor of Early Recurrence of Hepatocellular Carcinoma after Liver Transplantation and Effect of Pre-transplant Transarterial chemoembolization on Post-transplant Outcome.
- Author:
Chae Young LEE
1
;
Dong Goo KIM
;
Say June KIM
;
In Sung MOON
;
Myung Duk LEE
Author Information
1. Department of Surgery, The Catholic University of Korea College of Medicine, Seoul, Korea. kimdg@catholic.ac.kr
- Publication Type:Original Article
- Keywords:
Hepatocellular carcinoma (HCC);
Liver transplantation (LT);
Early recurrence (ER);
Transarterial chemoembolization (TACE)
- MeSH:
Adult;
alpha-Fetoproteins;
Carcinoma, Hepatocellular*;
Humans;
Liver Transplantation*;
Liver*;
Multivariate Analysis;
Prognosis;
Recurrence*;
Risk Factors*;
Serous Membrane;
Survival Rate
- From:Journal of the Korean Surgical Society
2007;72(5):379-386
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: The aims of this study were to find the risk factor and outcomes of patients with an early recurrence (ER) of a hepatocellular carcinoma (HCC) after liver transplantation (LT) and the actual impact of transarterial chemoembolization (TACE) before LT for a HCC on patient survival and HCC recurrence. METHODS: Ninety-eight cases of adult LT, performed between September 1995 and January 2006, were evaluated. The risk factors and prognosis of patient with a HCC after transplantation for an ER, defined as a recurrence within 6 months of transplantation, and the effects of Pre-LT TACE on the disease-free and overall survival rates, as well as the patterns of recurrence after LT, were studied. RESULTS: A total of 18 patients (18.4%) experienced a HCC recurrence after LT; 10 and 8 patients had early and late recurrences, respectively. From a univariate analysis, the serum alpha-fetoprotein (P=0.003), tumor size (P=0.003), serosa invasion (P=0.000), tumor grade (P=0.011) and vascular invasion (P=0.014) were statistically significant risk factors for an ER. From a multivariate analysis, the presence of serosa invasion of a HCC was the only independent risk factor for an ER (P=0.009; OR=9.407: 95% CI, 1.764~50.164). There was no difference in the disease free sur-vival and overall survival rates between the TACE and without TACE groups, but the extrahepatic recurrence rate was higher in the TACE than without TACE group. CONCLUSION: Serosa invasion by a HCC is independently associated with an ER of HCC after LT. Pre-LT TACE does not influence the disease-free and overall survivals after LT for a HCC.
