title: Hepatic artery chemoembolization for hepatocellular carcinoma recurrence confined to the transplanted liver.
abstract: BACKGROUND
  Careful hepatocellular carcinoma (HCC) case selection permits orthotopic liver transplantation with the expectation of around 70% plus 5-year survival. However, many patients have tumor recurrences and there is little literature guidance in the management of these patients.
  
  
  OBJECTIVE
  A retrospective examination of patients transplanted with HCC who subsequently developed liver recurrence.
  
  
  METHODS
  A case cohort series of patients was prospectively followed who had liver-only multifocal tumor recurrence of HCC after liver transplant and were then treated with chemoembolization.
  
  
  RESULTS
  All 6 patients had recurrent HCC. 2 had no response, 1 had stable disease, 2 had partial response (PR) and 1 had complete disappearance (CR) of disease. Their survival (in months) was: 13 (no response), 18 (no response), 12 (stable disease), 19 (PR), 30 (PR) and 50 (CR). There were no liver toxicities.
  
  
  CONCLUSIONS
  Chemoembolization for tumor recurrence in the transplanted liver is as safe as or safer than in the pre-transplant liver, due to the absence of cirrhosis. In this series, there were 3 of 6 responses with some long survivors.
authors.affiliation: Department of Nutrition and Experimental Biology, IRCCS Saverio de Bellis Medical Research Institute, Castellana Grotte, Italy.
authors.forename: Brian I
authors.initials: BI
authors.lastname: Carr
keywords: Chemoembolization; Hepatocellular carcinoma; Liver transplant; Tumor responses