Role of liver transplantation in the treatment of hepatocellular carcinoma.
The results obtained by liver transplantation (TX) (n = 105) for hepatocellular carcinoma (HCC) were compared with those achieved by hepatic resection (HX) (n = 76). Overall 1- to 5-year survival rates after TX were 66%, 49%, 39%, 36%, and 36%, and those after HX were 71%, 55%, 47%, 37%, and 33%, respectively. The survival rates after TX and HX correlated well with pTNM stages, and the overall survival rates were similar in each stage between the TX and the HX group. However, when HCC was associated with cirrhosis of the liver, the survival rates after TX were significantly higher than those after HX at each stage of pTNM classification. Tumor recurrence rate was high both after TX (43%) and HX (50%), particularly in stage IV-A. Tumor recurrence rate was significantly lower after TX than after HX in HCCs of stages II and III. Liver TX has established its definite role in the treatment of HCC, particularly in the presence of hepatic impairment or cirrhosis of the liver.
Iwatsuki
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Department of Surgery, University of Pittsburgh School of Medicine, Pennsylvania 15213.
Starzl
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D000206:Actuarial Analysis; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000401:mortality / Q000601:surgery*; D006498:Hepatectomy; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications; D008113:Liver Neoplasms / Q000150:complications / Q000401:mortality / Q000601:surgery*; D016031:Liver Transplantation; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D015996:Survival Rate