Background: The aim of this study was to identify predictors of survival of 58
patients, with hepatocellular carcinoma (HCC) in cirrhotic liver, treated by liver transplantation (OLTx).
Material/Methods: From January 2001 to December 2008 655 OLTx were
performed in 615 patients. HCC was diagnosed in 58 patients before OLTx and in 66 at histological examination of the explanted livers. 72% of the patients had met Milan criteria at histology.
Results: The median follow-up was 27 months (range, 1-96). We analyzed patient's age and gender, aetiology of liver disease, Child's score at transplantation, episodes of rejection, number and tumour's size, presence of vascular invasion and tumour's differentiation grade. There was no statistically significant  difference in survival among patients grouped according to the MELD staging system for HCC. Outcome of the 5-year survival of patients with low differentiated (G3) HCC was significantly worse than patients with moderately differentiated (G2) or well-differentiated (G1) HCC (respectively, G3 50%, G2 81%, and G1 86%, p<0.01). Patients with micro-vascular invasion had a worse 5-yr survival than patients without vascular invasion (42%vs. 80%, p<0.01).
Conclusions: The analysis indicates that histological grade of the tumour and
microscopic vascular invasion are the most predictive factors of overall survival in patients with cirrhosis after liver transplantation for HCC.