[Results of liver transplantation in patients with preoperative diagnosis of hepatocellular carcinoma].
BACKGROUND
[corrected] Hepatocellular carcinoma is the most frequent malignant hepatic tumor in humans, and its association with cirrhosis makes the therapeutic approach still a challenge. Liver transplantation is the treatment of choice for cirrhotic patients with unresectable early hepatocellular carcinoma


OBJECTIVE
To evaluate the post-transplant outcome of a cohort of 15 cirrhotic patients with preoperative diagnosis of unresectable early hepatocellular carcinoma according the Milan criteria who underwent liver transplantation between September 1991 and December 2003


METHODS
We retrospectively reviewed the clinical data from 15 liver transplant recipients and the explanted livers were assessed for the efficacy of preoperative therapy. Patient survival and tumor recurrence were evaluated as primary outcome measures


RESULTS
The mean age of the patients was 49.2 +/- 14.3 years and hepatitis C was the etiology of the underlying liver disease in 60%. Preoperative therapy, either chemoembolization or percutaneous ethanol injection, was performed in 12 (86%) patients. Complete necrosis of all tumoral lesions were observed in 5 of 12 patients (44,66%); all others had variable amounts of viable tumor in the explanted liver. Only 4 of the 15 (26.6%) explanted livers had microscopic vascular invasion. The median post-transplant follow-up was 33 months (range: 8-71 months) and no tumor recurrence was detected during this period. The only death was an early event not related to the tumor. The recurrence-free survival rates at 1 and 3 years were 93%


CONCLUSIONS
Liver transplantation has emerged as a good alternative for cirrhotic patients with early hepatocellular carcinoma not amenable to curative resection, offering excellent recurrence-free survival rates.
Parolin
Mônica Beatriz
MB
Serviço de Transplante Hepático, Universidade Federal do Paraná, PR. mbparolin@hotmail.com
Coelho
Júlio Cezar Uili
JC
Matias
Jorge Eduardo Fouto
JE
Baretta
Giorgio A P
GA
Ioshii
Sérgio Ossamu
SO
Nardo
Hygor
H
D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000601:surgery*; D018450:Disease Progression; D042241:Early Diagnosis; D006801:Humans; D008103:Liver Cirrhosis / Q000473:pathology / Q000601:surgery*; D008113:Liver Neoplasms / Q000473:pathology / Q000601:surgery*; D016031:Liver Transplantation / Q000473:pathology; D008875:Middle Aged; D011300:Preoperative Care; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D016019:Survival Analysis; D016896:Treatment Outcome