Comparison of hepatic resection and transplantation in the treatment of liver cancer.

One hundred twenty cirrhotic patients underwent hepatic resection (n = 60) or transplantation (n = 60) for hepatocellular carcinoma. Overall 3-year survival and survival without recurrence were 50% and 23% in the resection group compared to 47% and 44% in the transplantation group. Several characteristics of the tumors have been studied in order to determine prognostic factors in both groups. Thus, results for 3-year survival without recurrence following transplantation in patients with tumors < 3 cm/one or two nodules (83%) were superior to those following transplantation in patients with tumors larger than 3 cm or three or more nodules (37%) (P < 0.02) and to those following resection (10%). Thus, for patients with small tumors, until now the best candidates for resection, transplantation appears to have significantly better results. Conversely, for larger lesions, with three or more nodules, transplantation, in view of the critical donor situation, is probably not indicated.