title: [Value of perioperative adjuvant therapy in liver transplantation for advanced hepatocellular carcinoma].
abstract: OBJECTIVE
  To evaluate the clinical value of perioperative adjuvant chemotherapy in prevention of tumor recurrence and improvement of patient survival after liver transplantation for advanced hepatocellular carcinoma (HCC).
  
  
  METHODS
  Twenty patients with advanced HCC (pTNM stages III and IV a) receiving liver transplantation with preoperative transcatheter arterial chemoembolization (TACE) and postoperative adjuvant chemotherapy (ADM+5-Fu+CDDP) were retrospectively reviewed in comparison with 16 patients receiving liver transplantation only for tumor recurrence, cumulative and tumor-free survivals. The feasibility and side-effects of the treatments were also studied.
  
  
  RESULTS
  The recurrence rate was lower in the perioperative treatment group than in non-treatment group (12/20, 60.0% vs 11/16, 87.5%, P<0.05). The 1- and 2-year overall survival rates were 70.8% and 47.1% for the chemotherapy group and 43.8% and 20.5% for the non-chemotherapy group respectively, showing significant differences between them (P<0.05). The 1- and 2-year tumor-free survival rates were 60.6%, 40.5% and 33.6%, 15.6% in the two groups, respectively, with also significant differences (P<0.05).
  
  
  CONCLUSIONS
  Perioperative adjuvant treatment may significantly decrease the likeliness of tumor recurrence and prolong the survival of patients with advanced HCC after liver transplantation. Chemotherapy with ADM+5-Fu+CDDP can be effective and safe with only mild side-effects.
authors.affiliation: Department of Hepatobiliary Surgery, People's Hospital of Guangdong Province, Guangzhou 510080, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Sun
authors.forename: Bao-hua
authors.initials: BH
authors.lastname: Hou
authors.forename: Zhi-xiang
authors.initials: ZX
authors.lastname: Jian
authors.forename: Ying-liang
authors.initials: YL
authors.lastname: Ou
authors.forename: Jin-rui
authors.initials: JR
authors.lastname: Ou
mesh_terms: D000328:Adult; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy*; D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D019990:Perioperative Care; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome