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Optimization of Liver Transplantation as a Treatment of Intrahepatic Hepatocellular Carcinoma Recurrence After Partial Liver Resection: Experience of a Single European Series

World Journal of Surgery volume 34, pages 2146–2154 (2010)Cite this article

Abstract

Background

The aim of this study was to ascertain the outcome of liver transplantation (LT) due to hepatocellular carcinoma (HCC) in patients who had undergone previous liver resection (LR) for HCC.

Methods

A case-control study (1:2) was designed to compare patients who underwent LT due to HCC recurrence with a previous LR for HCC (study group) with those who underwent LT for primary HCC but without previous LR (control group).

Results

From January 1990 to December 2007, a total of 303 cirrhotic patients with primary HCC were evaluated for surgery. Primary LT was performed in 191 and LR in 100. When HCC recurrence was diagnosed after LR (69/100), 17 of the 69 (25%) patients underwent LT (study group). The median follow-up was 70 months (12.7–203.0 months). Disease-free survivals at 1, 3, and 5 years in the study group versus the control group were 86%, 68%, 58% vs. 97%, 93%, 89%, respectively (p < 0.04). The 1-, 3-, and 5-year actuarial patient survivals in the study group versus the control group were 59%, 52%, 52% vs. 85%, 76%, 65%, respectively (p = NS). Patients of the study group were divided into two groups according to the time to recurrence after LR: group 1 was <1 year, and group 2 was >1 year. Recurrence after LT was 75% in group 1 vs. 15.4% in group 2 (p < 0.03). The 1-, 3-, and 5-year actuarial patient survivals were 25%, 0%, 0% in group 1 and 69%, 69%, 69% in group 2, p < 0.02).

Conclusions

Liver transplantation can be safely performed after a previous LR for HCC. Patients with recurrence during the first year after hepatectomy have a poor prognosis after LT.

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Acknowledgments

Carlos Margarit, MD, PhD, as the Director of the Liver Transplant Unit from 1988–2005. Miss Christine O’Hara is thanked for valuable revision of the English version of the article. Esther Delgado is also thanked.

Author information

Affiliations

  1. HBP Surgery and Transplantation Department, Hospital Universitario Vall d’Hebron, Universidad Autónoma de Barcelona, Passeig de la Vall d’Hebron 119-129, 08035, Barcelona, Spain

    Gonzalo Sapisochin, Itxarone Bilbao, Joaquin Balsells, Cristina Dopazo, Mireia Caralt, Jose Luis Lázaro & Ramón Charco

  2. Hepatology Department, Hospital Universitario Vall d’Hebron, Universidad Autónoma de Barcelona, Barcelona, Spain

    Luis Castells

  3. Pathology Department, Hospital Universitario Vall d’Hebron, Universidad Autónoma de Barcelona, Barcelona, Spain

    Helena Allende

Authors
  1. Gonzalo Sapisochin
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  2. Itxarone Bilbao
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  3. Joaquin Balsells
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  4. Cristina Dopazo
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  5. Mireia Caralt
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  6. Jose Luis Lázaro
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  7. Luis Castells
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  8. Helena Allende
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  9. Ramón Charco
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Corresponding author

Correspondence to Gonzalo Sapisochin.

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Sapisochin, G., Bilbao, I., Balsells, J. et al. Optimization of Liver Transplantation as a Treatment of Intrahepatic Hepatocellular Carcinoma Recurrence After Partial Liver Resection: Experience of a Single European Series. World J Surg 34, 2146–2154 (2010). https://doi.org/10.1007/s00268-010-0583-4

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Keywords

  • Liver Transplantation
  • Liver Resection
  • Barcelona Clinic Liver Cancer
  • Milan Criterion
  • Microvascular Invasion