OBJECTIVE: The purpose of this study was to elucidate on the basis of clinicoradiologic features the patterns of and prognostic factors for recurrence of hepatocellular carcinoma after liver transplantation. MATERIALS AND METHODS: Institutional review board approval and informed consent were waived for this retrospective study. The subjects were 119 patients (102 men, 17 women; mean age, 49.8 years) with unresectable hepatocellular carcinoma who underwent liver transplantation from September 1996 to May 2005 and survived more than 2 months. We evaluated the incidence, imaging features, cumulative disease-free survival rate, and prognosis for recurrence of hepatocellular carcinoma. We examined clinical, therapeutic, and pretransplantation contrast-enhanced CT findings as prognostic factors and analyzed them with multivariate analysis. The median follow-up period was 17.2 months (range, 2.0-102.4 months). RESULTS: Recurrence was found in 16 (13.4%) of 119 patients and was most frequent in the liver, with no specific pattern. A multivariate stepwise Cox hazard model showed that the presence of portal venous thrombosis, more than 3-cm diameter of the largest tumor, and a viable tumor volume ratio greater than 10% were statistically independent prognostic factors. The 3- and 5-year cumulative disease-free survival rates for the entire cohort were 82.1% and 76.6%, respectively. Despite local therapy for a solitary metastatic lesion, recurrences were common. The mortality rate among patients with recurrent disease was 56.3%. CONCLUSION: Recurrence of hepatocellular carcinoma after liver transplantation is common, and the prognosis is not favorable. The presence of portal venous thrombosis and tumor size greater than 3 cm on baseline CT are significant risk factors. Aggressive interventional therapy seems to be helpful as a bridge to liver transplantation.
OBJECTIVE: The purpose of this study was to elucidate on the basis of clinicoradiologic features the patterns of and prognostic factors for recurrence of hepatocellular carcinoma after liver transplantation. MATERIALS AND METHODS: Institutional review board approval and informed consent were waived for this retrospective study. The subjects were 119 patients (102 men, 17 women; mean age, 49.8 years) with unresectable hepatocellular carcinoma who underwent liver transplantation from September 1996 to May 2005 and survived more than 2 months. We evaluated the incidence, imaging features, cumulative disease-free survival rate, and prognosis for recurrence of hepatocellular carcinoma. We examined clinical, therapeutic, and pretransplantation contrast-enhanced CT findings as prognostic factors and analyzed them with multivariate analysis. The median follow-up period was 17.2 months (range, 2.0-102.4 months). RESULTS: Recurrence was found in 16 (13.4%) of 119 patients and was most frequent in the liver, with no specific pattern. A multivariate stepwise Cox hazard model showed that the presence of portal venous thrombosis, more than 3-cm diameter of the largest tumor, and a viable tumor volume ratio greater than 10% were statistically independent prognostic factors. The 3- and 5-year cumulative disease-free survival rates for the entire cohort were 82.1% and 76.6%, respectively. Despite local therapy for a solitary metastatic lesion, recurrences were common. The mortality rate among patients with recurrent disease was 56.3%. CONCLUSION: Recurrence of hepatocellular carcinoma after liver transplantation is common, and the prognosis is not favorable. The presence of portal venous thrombosis and tumor size greater than 3 cm on baseline CT are significant risk factors. Aggressive interventional therapy seems to be helpful as a bridge to liver transplantation.
Authors: Annarita Pecchi; Giulia Besutti; Mario De Santis; Cinzia Del Giovane; Sofia Nosseir; Giuseppe Tarantino; Fabrizio Di Benedetto; Pietro Torricelli Journal: World J Hepatol Date: 2015-02-27
Authors: Bo Dai; Nida El Islem Guissi; Lydia Frenzel Sulyok; Mitchell G Bryski; Yiqing Wang; Dongjin Wang; Sunil Singhal; Huiming Cai Journal: Ann Transl Med Date: 2022-01
Authors: Thomas Tu; Magdalena A Budzinska; Annette E Maczurek; Robert Cheng; Anna Di Bartolomeo; Fiona J Warner; Geoffrey W McCaughan; Susan V McLennan; Nicholas A Shackel Journal: Int J Mol Sci Date: 2014-05-27 Impact factor: 5.923