Liver transplantation for hepatocellular carcinoma in cirrhotic patients.
A consecutive series of 88 patients underwent transplantation for hepatocellular carcinoma with cirrhosis over a 7-year period. Liver transplantation was indicated because of the tumor in 75 cases (85.2%); tumor was an incidental finding in 13 cases (14.8%). One patient was retransplanted due to primary nonfunction. The perioperative mortality was 4.5%. Tumor recurrence was observed in seven patients (7.95%) with incidental tumor recurrence in one case. As in patients with known primary liver tumors pretransplant, a thorough follow-up is advisable to establish an early diagnosis of recurrence. The actuarial survival for nonincidental hepatocellular carcinoma at 1, 3, and 5 year was 92%, 77%, and 75%, respectively. The differences in actuarial survival between hepatitis C negative and positive hepatocellular carcinoma were not significant (log-rank test P=.27), though there was a clear improvement in results (94%, 85%, and 78% vs 90%, 71%, and 71%), at 1, 3, and 5 years meaning that HCV infection is an important prognostic factor. Although transplantation for HCC has the advantages of removing the tumor and the cirrhotic liver, it remains a controversial topic. In our experience patients showing lesions less than 5 cm or three or fewer lesions experience an equivalent survival to transplanted patients who do not have cancer.
González-Uriarte
J
J
Liver Transplantation Unit, Hospital de Cruces, Baracaldo, Vizcaya, Spain.
Valdivieso
A
A
Gastaca
M
M
Errasti
G
G
Campo
M
M
Hernandez
M J
MJ
Montejo
M
M
Bustamante
J
J
Suarez
M J
MJ
Testillano
M
M
Fernandez
J R
JR
Ortiz de Urbina
J
J
D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000601:surgery*; D002423:Cause of Death; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007902:Length of Stay; D008103:Liver Cirrhosis / Q000601:surgery*; D008113:Liver Neoplasms / Q000601:surgery*; D016031:Liver Transplantation / Q000276:immunology / Q000401:mortality / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012008:Recurrence; D012189:Retrospective Studies; D016019:Survival Analysis; D013997:Time Factors
D007166:Immunosuppressive Agents