[Prognostic factors of hepatocellular carcinoma after liver transplantation].

BACKGROUND & OBJECTIVE: Liver transplantation (LT) is the best treatment for hepatocellular carcinoma (HCC), however, prognostic factors and selection of patients with HCC for LT are controversial. This study was to summarize our experience of LT for HCC, and identify prognostic factors.

METHODS: The clinical and follow-up data of 98 patients who underwent LT for HCC between Feb. 1999 and Dec. 2004 in our center were analyzed retrospectively. Their survival rates were calculated by Kaplan-Meier method. Log-rank test and Cox proportional hazards regression model were performed to analyze prognostic factors of HCC after LT. All statistical evaluations were performed using SPSS10.0 statistical software.

RESULTS: The follow-up time ranged from 1 to 78 months (median, 37.6 months). The mortality was 31.6%. The recurrence rate was 52.0%. The 1-, 3-, and 5-year survival rates were 84.9%, 49.3%, and 33.2%, respectively. Univariate analysis showed that portal vein tumor thrombus (PVTT), tumor size, serum alpha-fetoprotein (AFP) level, pTNM stage, and histological differentiation were prognostic factors of HCC after LT. Multivariate Cox regression analysis showed that the tumor size and PVTT were independent prognostic factors of HCC after LT.

CONCLUSIONS: Tumor size and PVTT are major prognostic factors of HCC after LT.