Improved results of a surgical resection for the recurrence of hepatocellular carcinoma after living donor liver transplantation.
OBJECTIVE
This study was designed to analyze the clinical outcomes of the recurrence of hepatocellular carcinoma (HCC) after living donor liver transplantation (LDLT) and to evaluate the efficacy of a surgical resection in treating such a recurrence.


METHODS
A total of 101 adult LDLT recipients with HCC between 1996 and 2007, including 17 who had recurrent HCC, were reviewed. The endpoints analyzed were survival from time of transplant and survival from time of recurrence. Recipient demographics, laboratory valuables, and tumor characteristics were analyzed. Any medical or surgical treatments that had been administered for any recurrence also were considered.


RESULTS
The mean duration until the initial recurrence after LDLT and the mean duration until death after the initial recurrence were 12.9 months and 12.0 months, respectively. A univariate analysis showed that gender, interferon therapy, early posttransplant tumor recurrence, and eligibility for a surgical resection all had a beneficial impact on survival from tumor recurrence. A surgical resection of tumor relapse was the most important variable in our study, and therefore the patients were divided into two groups: surgical therapy group (n = 9), and nonsurgical therapy group (n = 7). Interestingly, the overall survival rates of the surgical group were significantly better than those of the nonsurgical group and were similar to that of the patients without HCC recurrence.


CONCLUSIONS
Surgical therapy might be useful for patients who experience a recurrence of HCC after LDLT to improve their outcome, when such treatment is available.
Taketomi
Akinobu
A
Department of Surgery and Science, Graduate School of Medicine, Kyushu University, Higashi-ku, Fukuoka, Japan. taketomi@surg2.med.kyushu-u.ac.jp
Fukuhara
Takasuke
T
Morita
Kazutoyo
K
Kayashima
Hiroto
H
Ninomiya
Mizuki
M
Yamashita
Yoichi
Y
Ikegami
Toru
T
Uchiyama
Hideaki
H
Yoshizumi
Tomoharu
T
Soejima
Yuji
Y
Shirabe
Ken
K
Maehara
Yoshihko
Y
D000328:Adult; D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology / Q000601:surgery*; D016031:Liver Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome