Indian Journal of Gastroenterology

, Volume 36, Issue 2, pp 117–125 | Cite as

Hepatocellular carcinoma biology predicts survival outcome after liver transplantation in the USA

  • Mohamed Abd El-Fattah
Original Article



The aim of this study is to evaluate the clinicopathologic prognostic factors of cancer-specific survival (CSS) in hepatocellular carcinoma (HCC) patients who underwent liver transplantation (LT) stratified by tumor size.


From the Surveillance, Epidemiology, and End Results (SEER) 18 registries (2004–2012), we retrieved data of 570 patients who underwent LT for a solitary primary HCC lesion ≤5 cm. A two multivariable Cox models were constructed to identify prognostic factors of CSS in a two different tumor sizes (2 cm cutoff).


Out of 570 HCC patients (median age 57 years), 16% had microvascular invasion (MVI) and 12% had a poorly differentiated tumor. Male sex (odds ratio [OR] 2.6), tumor size >2 cm (OR 1.78), elevated AFP (OR 2.31), and poor tumor differentiation (OR 2.59) are significant predictors of MVI. With a median follow up of 41.5 months (range 1–107 months), the 5-year CSS rate was 90% in the absence of MVI compared to 75% in the presence of MVI (p<0.001). Multivariate models revealed that age ≥60 years (hazard ratio [HR] 2.08), MVI (HR 2.26), and poor tumor differentiation (HR 2.42), were significant risk factors of a dismal CSS with HCC size >2 cm, but not with HCC ≤2 cm.


Primary HCC tumor size ≤2 cm had an excellent prognosis after LT and was not affect by the presence of MVI or poor tumor differentiation.


HCC Hepatocellular carcinoma Liver transplantation Microvascular invasion Prognosis 


Compliance with ethical standards


This study was not funded.

Conflict of interest

MA El-F declares that he has no conflict of interest.

Human informed consent

There were no human consents, as this study was a retrospective database report.


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Copyright information

© Indian Society of Gastroenterology 2017

Authors and Affiliations

  1. 1.Department of Internal Medicine, Faculty of MedicineSuez Canal UniversityIsmailiaEgypt

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