title: Long-term outcome of liver transplantation as treatment modality in patients with hepatocellular carcinoma in cirrhosis: a single-center experience.
abstract: BACKGROUND
  Hepatocellular carcinoma (HCC) is among the most frequent malignant diseases worldwide. In the vast majority of cases, it is associated with liver cirrhosis. Liver transplantation (OLT) is potentially the gold standard treatment for patients suffering HCC in cirrhosis, because of synchronous eradication of HCC and of the underlying hepatic disease. The aim of this study was to evaluate long-term outcomes of OLT in HCC patients.
  
  
  METHODS
  Between January 2000 and December 2011, 43 patients who were diagnosed with HCC in liver cirrhosis and underwent OLT in our department, were identified from a prospective database. All patients received their grafts from deceased donors. We analyzed demographic data, laboratory values, number and size of lesions, primary liver disease, diagnostic methods, bridging therapy modalities, and postoperative outcomes, including complications, recurrences, and their treatment.
  
  
  RESULTS
  Patient follow-up as of January 2012 or to death ranged from 0 to 138 months (median, 59; mean, 63). None of the patients were lost to follow-up. The gender bias was 85%:15% (male:female) and the median age, 57.8 years (range, 44-69). The most common underlying diseases for cirrhosis and HCC were alcoholic (n = 12) and hepatitis C (n = 16). Thirty-one subjects underwent bridging therapy through transarterial chemoembolization (TACE), and/or radiofrequency ablation. All patients underwent OLT within the Milan criteria according to the preoperative evaluation and histopathologic examination of the explanted liver. Twenty-one of them suffered postoperative complications (48.8%). HCC recurrence, which occurred in 5 (10.4%), was treated by surgery (n = 3), systemic chemotherapy with sorafenib (n = 1), or TACE (n = 1).
  
  
  CONCLUSIONS
  OLT for HCC in cirrhosis, displays a relatively high complication rate. It shows good survivals with and low recurrence.
authors.affiliation: Department of Surgery, University of Erlangen-Nuremberg, Erlangen, Germany.
authors.forename: V
authors.initials: V
authors.lastname: Müller
authors.forename: T
authors.initials: T
authors.lastname: Förtsch
authors.forename: M
authors.initials: M
authors.lastname: Gündel
authors.forename: R S
authors.initials: RS
authors.lastname: Croner
authors.forename: M
authors.initials: M
authors.lastname: Langheinrich
authors.forename: S
authors.initials: S
authors.lastname: Yedibela
authors.forename: C
authors.initials: C
authors.lastname: Lohmüller
authors.forename: M
authors.initials: M
authors.lastname: Küffner
authors.forename: W
authors.initials: W
authors.lastname: Hohenberger
authors.forename: A
authors.initials: A
authors.lastname: Perrakis
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000601:surgery*; D005260:Female; D005858:Germany; D006801:Humans; D008113:Liver Neoplasms / Q000150:complications / Q000601:surgery*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome