Prognostic factors in patients with recurrent hepatocellular carcinoma treated with salvage liver transplantation: a single-center study
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Pusen Wang1,*, Hao Li1,*, Baojie Shi1, Weitao Que1, Chunguang Wang1, Junwei Fan1, Zhihai Peng1, Lin Zhong1
1Department of General Surgery, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, 200080, Shanghai, China
*These authors have contributed equally to this work
Zhihai Peng, e-mail: [email protected]
Lin Zhong, e-mail: [email protected]
Keywords: hepatocellular carcinoma, liver resection, prognosis, recurrence, salvage liver transplantation
Received: February 02, 2016 Accepted: April 16, 2016 Published: April 27, 2016
Although salvage liver transplantation (LT) has been widely adopted as a treatment for recurrent hepatocellular carcinoma(HCC), candidate selection criteria have not been established. This single-center study aimed to identify risk factors associated with HCC recurrence and survival following salvage LT. The study included 74 patients treated with salvage LT between October 2001 and February 2013. The median follow-up was 37.2 months after LT. There were 29 cases of HCC recurrence and 31 deaths following LT. Microvascular invasion at the time of liver resection, a time interval to post-LR HCC recurrence of ≤ 12months, an alpha-fetoprotein level at LT greater than 200 ng/mL, and having undergone LT outside of the UCSF criteria were independent risk factors for HCC recurrence after salvage LT. Patients with no more than one risk factor had a 5-year recurrence-free survival rate of 71.2% compared to 15.9% in patients with two or more risk factors. These findings suggest that to avoid post-LT HCC recurrence and a dismal prognosis, patients with no more than one risk factor for recurrence should be given priority for salvage LT. These criteria may improve the outcomes of patients treated with salvage LT and facilitate the effective use of limited organ supplies.
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