Study On The Characteristics Of Tumor Recurrence Of Hepatocellular Carcinoma After Liver Transplantation

Objective To explore the characteristics of tumor recurrence of hepatocellular carcinoma (HCC) after liver transplantation (LT), including sites, time and risk factors of recurrence, and provide evidence for prediction and prevention of recurrence after LT, and evaluation of the recipient before LT. Methods Preoperative, intraoperative and postoperative data of consecutive 81 cases of HCC undergoing LT were prospectively collected in our hospital from January 2005 to August 2006, 6 cases of death in period of hospitalization excluded. Regular follow-up were performed, another 6 cases were excluded, including 5 cases who died of no recurrence and 1 case dropped off, 69 cases were followed up for 3 to 22 months. Tumor recurred in 33 cases in which risk factors were analyzed using SPSS statistic software with control group. Results The number of tumor were greater and the size of tumor were larger in recurrence group than that in no-recurrence group. Preoperative level of alpha-fetoprotein (AFP) over 400ng/ml, exceeding Milan-criteria, pTNM staging being pT3 or pT4, and vascular invasion were risk factors for tumor recurrence. Multivariate analysis demonstrated that pTNM staging was independent risk factor for tumor recurrence after LT. The vascular invasion was risk factor for tumor recurrence in short period after LT. Conclusion Tumor recurrence occurred more outside the liver at first after LT. Large HCC had characteristics of understaging and vascular invasion, and recurred early. The pTNM staging were major risk factors for tumor recurrence. Vascular invasion resulted in tumor recurrence in short period.