title: Child-Pugh A hepatitis B-related cirrhotic patients with a single hepatocellular carcinoma up to 5 cm: liver transplantation vs. resection.
abstract: OBJECTIVE
  This study aims to analyze the outcomes of patients with Child-Pugh A class cirrhosis and a single hepatocellular carcinoma (HCC) up to 5 cm in diameter who underwent liver transplantation vs. resection.
  
  
  METHODS
  During 2007 to 2012, 282 Child-Pugh A cirrhotic patients with a single HCC up to 5 cm in diameter either underwent liver resection (N = 243) or received liver transplantation (N = 39) at our center. Patient and tumor characteristics and outcomes were analyzed.
  
  
  RESULTS
  Patients who underwent liver transplantation had a better recurrence-free survival (RFS) vs. those who underwent liver resection. However, the 5-year survival rates after these two treatments were comparable. Similar results were observed when we analyzed patients with a HCC less than 3 cm, and for patients with portal hypertension. In the multivariate analysis, tumor differentiation, difference of primary treatment, and presence of microvascular invasion were associated with postoperative recurrence. However, only differentiation negatively impacted overall survival after operation.
  
  
  CONCLUSIONS
  Although more recurrences were observed in Child A cirrhotic patients with a single HCC up to 5 cm after liver resection, liver resection offers a similar 5-year survival to liver transplantation, even for patients with portal hypertension.
authors.affiliation: Division of Liver Surgery and Liver Transplantation, West China Hospital of Sichuan University, Chengdu, 610041, China.
authors.forename: Chuan
authors.initials: C
authors.lastname: Li
authors.forename: Wen-Jiang
authors.initials: WJ
authors.lastname: Zhu
authors.forename: Tian-Fu
authors.initials: TF
authors.lastname: Wen
authors.forename: Yan
authors.initials: Y
authors.lastname: Dai
authors.forename: Lu-Nan
authors.initials: LN
authors.lastname: Yan
authors.forename: Bo
authors.initials: B
authors.lastname: Li
authors.forename: Jia-Yin
authors.initials: JY
authors.lastname: Yang
authors.forename: Wen-Tao
authors.initials: WT
authors.lastname: Wang
authors.forename: Ming-Qing
authors.initials: MQ
authors.lastname: Xu
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000473:pathology / Q000601:surgery* / Q000821:virology; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy; D019694:Hepatitis B, Chronic / Q000150:complications*; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications* / Q000473:pathology / Q000821:virology; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery* / Q000821:virology; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016019:Survival Analysis; D016896:Treatment Outcome