title: Treatment of recurrent hepatocellular carcinoma after liver transplantation.
abstract: OBJECTIVE
  Liver transplantation (LT) is a curative treatment for localized hepatocellular carcinoma (HCC), but the recurrence rate after LT is about 10-20%, with a dismal prognosis. Little data exist as to the natural history, treatment outcome and optimal treatment of recurrent HCC after LT. We reviewed various treatment modalities given to patients with recurrent HCC after LT.
  
  
  METHODS
  Among 132 patients who underwent LT for localized HCC, we retrospectively reviewed medical records of 39 of the 132 patients who developed recurrent HCC after LT. We analyzed the clinical outcome of various treatment modalities and treatment-related adverse events.
  
  
  RESULTS
  A total of 39 (29%) of the original 132 patients had recurrent HCC, most recurrences (82%) having occurred within 1 year after LT and involved extrahepatic lesions. Only seven patients had recurrent disease limited to the liver. The median overall survival from the initial treatment of all relapsed patients was 6.9 months. There were various initial treatment modalities, namely palliative systemic chemotherapy, trans-catheter arterial chemo-embolization/infusion (TACE/I), radiation therapy (RT), surgical resection and no treatment. The median overall survival was 9.5 months for first-line chemotherapy, including those who had prior local therapy, 6.3 months TACE/I and 6.9 months for RT.
  
  
  CONCLUSIONS
  Various clinical approaches have been used to treat patients with recurrent HCC after LT in a clinical setting. More effective strategies and clinical guidelines for recurrent HCC following LT must be established.
authors: Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
authors: Hye Ryun
authors: HR
authors: Kim
authors: Seong Ha
authors: SH
authors: Cheon
authors: Sun Young
authors: SY
authors: Rha
authors: Soohyeon
authors: S
authors: Lee
authors: Kwang-Hyub
authors: KH
authors: Han
authors: Chae Yoon
authors: CY
authors: Chon
authors: Jong Doo
authors: JD
authors: Lee
authors: Jin Sil
authors: JS
authors: Sung
authors: Hyun Cheol
authors: HC
authors: Chung
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D016031:Liver Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D010166:Palliative Care; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome