title: Treatment of hepatocellular carcinoma in the transplant era.
abstract: BACKGROUND
  hepatocellular carcinoma (HCC) is one of the most frequent malignant diseases of the liver. It is clearly related to cirrhosis, especially to that caused by liverbound viruses. This study addresses the behavior of this disease in patients treated under different protocols at two third-level hospitals.
  
  
  METHODS
  we conducted a longitudinal, prospective and retrospective study including patients diagnosed with HCC and invasively treated at Hermanos Ameijeiras and Juan Canalejo Hospitals. Subjects were grouped according to treatment and were compared with those patients who underwent liver transplant. Mean comparison tests were used as well as survival analysis.
  
  
  RESULTS
  overall recurrence patterns showed variable recurrence for all patients with a clear benefit for the transplanted group of patients including those with expanded criteria. Overall survival analysis at 3, 5 and 10 years showed that (patient) survival was 70%, 59% and 55%, respectively, for the transplanted group. On the other hand, those patients who did not undergo transplant showed significantly lower survival rates of 40%, 17% and 9%, respectively.
  
  
  CONCLUSIONS
  this study, like others, demonstrated a clear benefit for liver transplant in the treatment of HCC. This is more evident in patients with an underlying liver disease, as long as low-recurrence selection criteria are considered. These results are important in the evaluation of effectiveness of treatments considering both groups are comparable.
authors.affiliation: Servicio de Trasplantes Abdominales, Hospital Clínico Quirúrgico Hermanos Ameijeiras, La Habana, Cuba. gala32486@yahoo.com
authors.forename: Boris
authors.initials: B
authors.lastname: Gala-López
authors.forename: Manuel
authors.initials: M
authors.lastname: Gómez-Gutiérrez
authors.forename: Carlos
authors.initials: C
authors.lastname: Fernández-Sellés
authors.forename: Francisco
authors.initials: F
authors.lastname: Arnal-Monreal
authors.forename: José Antonio
authors.initials: JA
authors.lastname: Copo-Jorge
authors.forename: Fernando
authors.initials: F
authors.lastname: González-Castillo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000628:therapy*; D006801:Humans; D008113:Liver Neoplasms / Q000628:therapy*; D016031:Liver Transplantation; D008875:Middle Aged; D011446:Prospective Studies; D012189:Retrospective Studies