Experience with liver transplantation for hepatocellular carcinoma

Research output: Contribution to journalArticle

Abstract

The role of orthotopic liver transplantation in the treatment of patients with cirrhosis and hepatocellular carcinoma is controversial, and determining which patients are likely to have a good outcome after liver transplantation is difficult. We studied 83 patients with cirrhosis who had small unresectable hepatocellular carcinomas and who underwent liver transplantation. In 92.8% of the patients the cirrhosis was related to infection with HBV, hepatitis C virus, or both. The presence of tumour was confirmed by biopsy or serum alpha-fetoprotein (AFP) assay. The eligibility criteria for transplantation were the presence of a tumour 5 cm or less in diameter in patients with single hepatocellular carcinoma and no more than three tumour nodules, each 3 cm or less in diameter, in patients with multiple tumours. Fifty-six patients with sufficient hepatic function underwent tumour treatment, mainly chemoembolisation, before transplantation. After liver transplantation, the patients were followed prospectively for a median of 29 months (range, 6 to 66). No anti-cancer treatment was given after transplantation. The overall mortality rate was 20.5%. After 5-yr, the actuarial survival rate was 68% and the rate of recurrence-free survival was 87%. Hepatocellular carcinoma recurred in 8 patients (9.6%). The overall and recurrence-free survival rates at 5 yr among the 60 patients (72.2% of the total) who met the pre-determinated criteria for the selection of small hepatocellular carcinomas at pathological review of the explanted liver were 77 and 94%, respectively, whereas the rates in the 23 patients (27.8%) whose tumours exceeded these limits were 44 and 67%, respectively (p = 0.01). In this group of 83 patients with early stage tumours, tumour node, metastasis status, the number of tumours, the serum AFP concentration, treatment received before transplantation, and 10 other variables were not significantly correlated with survival. Liver transplantation is an effective treatment for small, unresectable hepatocellular carcinomas in patients with cirrhosis.

Original languageEnglish
Pages (from-to)368-373
Number of pages6
JournalFORUM - Trends in Experimental and Clinical Medicine
Volume7
Issue number4
Publication statusPublished - 1997

Keywords

  • Cirrhosis
  • Hepatocellular carcinoma
  • Liver transplantation
  • Liver tumour

ASJC Scopus subject areas

  • Medicine(all)

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