title: Influence of Waiting List in Recurrence Disease of Hepatocellular Carcinoma.
abstract: BACKGROUND
  We describe the results of our liver transplantation (LT) patients for hepatocellular carcinoma (HCC) in 2004 to 2012 to determine the differences on the basis of time on the waiting list to establish the risk of recurrence of liver disease.
  
  
  METHODS
  Clinical variables were recorded for both donors and recipients as well as variables of diagnosis, the use of transarterial chemoembolization during the waiting list time (WLT), complications, re-transplantation, and exitus. Fifty-eight patients were analyzed. Mean age was 57 ± 8 years (men, 83%; 48 patients). Viral etiology of HCC was 50% (n = 29); alcoholic, 26% (n = 15); and others, 24% (n = 14).
  
  
  RESULTS
  Exitus was established in 24 patients (41%); only 5 patients (7%) were attributable to HCC. In the cohort of patients with less than 6 months of WLT, we registered both higher rates of downstaging protocols (10.7% vs 7.5%) and tumor size (3 cm vs 2 cm) compared with the other group. Bivariate studies were conducted according to the WLT (WLT <6 months, WLT ≥6 months), finding differences in recurrence of liver disease (P < .05). This fact was confirmed after a binary logistic regression.
  
  
  CONCLUSIONS
  Our results in a subgroup of less than 6 months of WLT included patients with increased tumor size or presentation of multiple nodes, with a worse prognosis and therefore to be prioritized in the treatment of LT. Therefore, in our population there is a significant risk of tumor recurrence in patients with less WLT for LT, but it cannot be overestimated to all type of patients with HCC.
authors.affiliation: General, Digestive Surgery and Liver Transplantation Department, Virgen de las Nieves University Hospital (University Hospital Centre of Granada), Granada, Spain. Electronic address: sanmiguel.carlos@gmail.com.
authors.forename: C
authors.initials: C
authors.lastname: San Miguel
authors.affiliation: General, Digestive Surgery and Liver Transplantation Department, Virgen de las Nieves University Hospital (University Hospital Centre of Granada), Granada, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Vílchez
authors.affiliation: General, Digestive Surgery and Liver Transplantation Department, Virgen de las Nieves University Hospital (University Hospital Centre of Granada), Granada, Spain.
authors.forename: T
authors.initials: T
authors.lastname: Villegas
authors.affiliation: General, Digestive Surgery and Liver Transplantation Department, Virgen de las Nieves University Hospital (University Hospital Centre of Granada), Granada, Spain.
authors.forename: K M
authors.initials: KM
authors.lastname: Granero
authors.affiliation: General, Digestive Surgery and Liver Transplantation Department, Virgen de las Nieves University Hospital (University Hospital Centre of Granada), Granada, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Becerra
authors.affiliation: Hepatology Department, Virgen de las Nieves University Hospital (University Hospital Centre of Granada), Granada, Spain.
authors.forename: M Á
authors.initials: MÁ
authors.lastname: López
authors.affiliation: Department of Research, Virgen de las Nieves University Hospital (University Hospital Centre of Granada), Granada, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Expósito
authors.affiliation: General, Digestive Surgery and Liver Transplantation Department, Virgen de las Nieves University Hospital (University Hospital Centre of Granada), Granada, Spain.
authors.forename: Y
authors.initials: Y
authors.lastname: Fundora
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000473:pathology* / Q000628:therapy; D004621:Embolization, Therapeutic / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology* / Q000628:therapy; D016031:Liver Transplantation / Q000009:adverse effects / Q000706:statistics & numerical data*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology / Q000209:etiology*; D012307:Risk Factors; D013997:Time Factors; D014850:Waiting Lists