Resection et transplantation hepatique pour carcinome hepatocellulaire chez les malades atteints de cirrhose

Objectives. - Liver resection and liver transplantation are the only curative treatments for hepatocellular carcinoma in patients with cirrhosis. The aim of this retrospective study was to compare survival and tumor recurrence in patients with cirrhosis after hepatic resection or liver transplantation for hepatocellular carcinoma in patients with cirrhosis. Methods. - Between March 1988 and March 1995, 34 patients underwent liver resection and 30 patients with cirrhosis had liver transplantation for hepatocellular carcinoma. The probability of survival and recurrence were studied according to clinical, biological and pathological factors, defined in liver specimens. Comparisons were performed by the actuarial method and log rank test. Results. - Five-year survival after resection and transplantation was 13 % and 32.6 %, respectively, and 5-year recurrence was 92.6 % and 40.9 %, respectively (P 5 cm and/or number of nodules > 3), and patients with small carcinoma (diameter ≤5 cm and number of nodules ≤3). The five-year survival rate of large hepatocellular carcinoma was 17.3 % after resection and 0 % after transplantation. The five-year survival rate of small hepatocellular carcinoma was 0 % after resection and 69.3 % after transplantation (P