Influence of prognostic factors on the outcome of liver transplantation for hepatocellular carcinoma on cirrhosis: A univariate and multivariate analysis

Massimo Del Gaudio, Gian Luca Grazi, Alfonso Principe, Matteo Ravaioli, Giorgio Ercolani, Matteo Cescon, Giovanni Varotti, Andrea Gardini, Antonino Cavallari

Research output: Contribution to journalArticlepeer-review

Abstract

Background/Aims: Hepatocellular carcinoma is related to liver cirrhosis in 70-85% cases. During the '80s, the best treatment was represented by liver resection. Recently, liver transplantation has been introduced as an optimal therapeutic alternative. The purpose of this study is to select the best candidates for liver transplantation considering several prognostic factors that are related to tumor characteristics. Methodology: Among 573 liver transplantations, we have retrospectively analyzed 87 patients undergoing liver transplantation for hepatocellular carcinoma on cirrhosis; in 30 (34.5%) patients, hepatocellular carcinoma was an incidental finding in the surgical specimen. Results: Operative mortality was 2.2% (2/87). Twenty-five patients died during the follow-up. The main cause of death was represented by tumor recurrence in 10.3% of cases. The 3-year and 5-year overall survival was 71.6% and 66.2% respectively. On a univariate analysis, the only variable significantly related with overall-survival was alpha-fetoprotein levels (p=0.01). Furthermore, alpha-fetoprotein, the diameter of tumor greater than 3cm, the presence of satellite nodules, Edmonson's grade III-IV, micro-macro vascular thrombosis, and TNM stadium III-IV were significantly related with the development of tumor recurrence. On a multivariate analysis, only alpha-fetoprotein (p=0.01, Risk ratio = 2.7) resulted as a risk independent factor of patient overall-survival; vascular invasion (p=0.02, Risk ratio = 2.1) was predictive of tumor recurrence. Conclusions: Liver transplantation is a good therapeutic option in a selected group of patients, with a small nodule (

Original languageEnglish
Pages (from-to)510-514
Number of pages5
JournalHepato-Gastroenterology
Volume51
Issue number56
Publication statusPublished - Mar 2004

Keywords

  • Cirrhosis
  • Hepatocellular carcinoma
  • Recurrence
  • Resection
  • Transplantation

ASJC Scopus subject areas

  • Gastroenterology

Fingerprint Dive into the research topics of 'Influence of prognostic factors on the outcome of liver transplantation for hepatocellular carcinoma on cirrhosis: A univariate and multivariate analysis'. Together they form a unique fingerprint.

Cite this