title: Recurrent Hepatocellular Carcinoma After Liver Transplantation: Analysis of Risk Factors.
abstract: BACKGROUND
  Survival after orthotopic liver transplantation (LT) for hepatocellular carcinoma (HCC) is influenced by tumor recurrence. This study examines the survival of patients who underwent LT for HCC and developed recurrence of tumor after transplantation.
  
  
  METHODS
  A retrospective analysis was performed of the 200 patients who underwent LT secondary to HCC from 1990 to 2014. We excluded 19 patients from the study owing to early postoperative deaths in the 1st month. We divided our sample into 2 groups according to the presence of recurrence. We performed a univariate analysis to identify variables that are significantly associated with the risk of recurrence. Afterward we use multivariate analysis regression analysis to find independent significance.
  
  
  RESULTS
  Univariate analysis shows significant relationship between high Edmondson-Steiner grades (G3-G4) and the development of tumor recurrence. Tumor size, vascular invasion, and capsular invasion were found to be independent risk factors of tumor recurrence in the multivariate analysis.
  
  
  CONCLUSIONS
  Tumor recurrence defines survival of patients who underwent LT for HCC. In this study we discuss which histologic factor are associated with higher risk of tumor recurrence, and therefore a negative the impact on patient's survival.
authors.affiliation: Division of Hepatobiliary Surgery and Liver Transplantation, Department of General Surgery, University Hospital Virgen del Rocío, Sevilla, Spain. Electronic address: eperepo@gmail.com.
authors.forename: E
authors.initials: E
authors.lastname: Perea Del Pozo
authors.affiliation: Division of Hepatobiliary Surgery and Liver Transplantation, Department of General Surgery, University Hospital Virgen del Rocío, Sevilla, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Bernal Bellido
authors.affiliation: Division of Hepatobiliary Surgery and Liver Transplantation, Department of General Surgery, University Hospital Virgen del Rocío, Sevilla, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Sendín Matín
authors.affiliation: Division of Hepatobiliary Surgery and Liver Transplantation, Department of General Surgery, University Hospital Virgen del Rocío, Sevilla, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Cepeda Franco
authors.affiliation: Division of Hepatobiliary Surgery and Liver Transplantation, Department of General Surgery, University Hospital Virgen del Rocío, Sevilla, Spain.
authors.forename: J M
authors.initials: JM
authors.lastname: Álamo Martínez
authors.affiliation: Division of Hepatobiliary Surgery and Liver Transplantation, Department of General Surgery, University Hospital Virgen del Rocío, Sevilla, Spain.
authors.forename: G
authors.initials: G
authors.lastname: Suarez Artacho
authors.affiliation: Division of Hepatobiliary Surgery and Liver Transplantation, Department of General Surgery, University Hospital Virgen del Rocío, Sevilla, Spain.
authors.forename: L M
authors.initials: LM
authors.lastname: Marín Gómez
authors.affiliation: Division of Hepatobiliary Surgery and Liver Transplantation, Department of General Surgery, University Hospital Virgen del Rocío, Sevilla, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Padillo Ruiz
authors.affiliation: Division of Hepatobiliary Surgery and Liver Transplantation, Department of General Surgery, University Hospital Virgen del Rocío, Sevilla, Spain.
authors.forename: M Á
authors.initials: MÁ
authors.lastname: Gomez Bravo
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000209:etiology* / Q000601:surgery; D012189:Retrospective Studies; D012307:Risk Factors