title: Recurrence of hepatocellular carcinoma after living donor liver transplantation: what is the current optimal approach to prevent recurrence?
abstract: BACKGROUND
  Liver transplantation plays an important role in the multimodal treatment options for patients with hepatocellular carcinoma (HCC). However, there has been little information about the prognosis for HCC recurrence after living donor liver transplantation (LDLT).
  
  
  METHODS
  We retrospectively analyzed 164 HCC patients who underwent LDLT at our institution between February 1999 and March 2009.
  
  
  RESULTS
  In all, 23 of 164 liver recipients developed HCC recurrence 1 to 44 months (median 8 months) after LDLT. The 5-year survival was significantly lower for patients with recurrence than for patients without recurrence (14 vs. 82%; p<0.0001). The 3-year survival was significantly lower for patients with early recurrence (≤1 year) than for patients with late recurrence (>1 year) (8 vs. 40%; p=0.0082). Concerning sites of first tumor recurrence, the 3-year survival rate in patients with recurrence in the graft liver was significantly higher than that of patients with recurrence to other organs (50 vs. 17%, respectively; p=0.0421).
  
  
  CONCLUSIONS
  As the prognosis of patients with HCC recurrence is quite poor, currently the optimal method of preventing HCC recurrence would be the use of appropriate criteria to select candidates for LDLT.
authors.affiliation: Division of Hepato-Biliary-Pancreatic and Transplant Surgery, Department of Surgery, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan, kaido@kuhp.kyoto-u.ac.jp.
authors.forename: Toshimi
authors.initials: T
authors.lastname: Kaido
authors.forename: Akira
authors.initials: A
authors.lastname: Mori
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Ogura
authors.forename: Koichiro
authors.initials: K
authors.lastname: Hata
authors.forename: Atsushi
authors.initials: A
authors.lastname: Yoshizawa
authors.forename: Taku
authors.initials: T
authors.lastname: Iida
authors.forename: Shinji
authors.initials: S
authors.lastname: Uemoto
mesh_terms: D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis; D001707:Biopsy, Needle; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D016031:Liver Transplantation / Q000009:adverse effects* / Q000379:methods; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods; D009364:Neoplasm Recurrence, Local / Q000401:mortality* / Q000517:prevention & control* / Q000628:therapy; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D018709:Statistics, Nonparametric; D016019:Survival Analysis; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor