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23 August 2019 : Original article  

Recurrence of Hepatocellular Carcinoma After Liver Transplantation: A Single-Center Experience

Samir Zeair1AB, Justyna Rajchert2BCF, Robert Stasiuk1BC, Sławomir Cyprys1B, Janusz Miętkiewski3BD, Katarzyna Zasada-Cedro4D, Ewa Karpińska2B, Marta Duczkowska4C, Miłosz Parczewski5C, Marta Wawrzynowicz-Syczewska2ADEG*

DOI: 10.12659/AOT.918150

Ann Transplant 2019; 24:499-505

Abstract

BACKGROUND: There is a worldwide increase in use of liver transplantation (LT) for treatment of hepatocellular carcinoma (HCC). We analyzed our experience with LT for HCC to determine long-term and recurrence-free survival, accuracy of imaging diagnosis of HCC compared to the explant pathology, recurrence rate of HCC, and predictors of recurrence.

MATERIAL AND METHODS: The whole explant was examined by the same pathologist and compared with the baseline diagnosis established according to clinical, laboratory, and radiological data. A group of patients with pathologically confirmed HCC was characterized, with special attention to etiology, survival, recurrence, and diagnostic accuracy of imaging techniques.

RESULTS: Among 718 patients transplanted from 2000 to 2018 in our center, HCC was found in 166 explanted livers. In 42 cases the clinical diagnosis of HCC was not accurate, being either false positive or negative; however, the specificity and sensitivity of CT/MRI in HCC recognition was 97.87% and 88.24%, respectively. Five- and 10-year survival was 81.27% and 66.57%, respectively, and it was inferior to the overall survival. The recurrence rate was 9.6% with a median time to recurrence of 14 months and a median survival time of 9 months. Poor differentiation of HCC and HCV etiology of the baseline disease, but not previous DAA treatment, were the risk factors of HCC recurrence.

CONCLUSIONS: Adherence to strictly defined selection criteria for LT in HCC patients guarantees the success of LT in HCC treatment.

Keywords: Carcinoma, Hepatocellular, Liver Transplantation, Recurrence, Liver Neoplasms, Risk Factors, Survival Rate

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Annals of Transplantation eISSN: 2329-0358
Annals of Transplantation eISSN: 2329-0358