The essential predictors of recurrence in patients with hepatocellular carcinoma after liver transplantation

Abstract

Aim: Liver transplantation is the optimal treatment for a selected group of patients with hepatocellular carcinoma (HCC). Post-transplant recurrence is common and markedly reduces the long-term survival of patients with HCC. The present study focuses on determining the predictive factors affecting the recurrence of HCC. Materials and Methods: Data of 106 patients with HCC who underwent liver transplantation between May 2012 and June 2018 were collected retrospectively. Variables were as follows: age, gender, preoperative alpha-fetoprotein (AFP) levels, MELD score, number of tumors, total tumor size and histological features. Results: Recurrence-free survival and overall survival rates were 91.5\% and 94.3\%, respectively. Cox regression analysis demonstrated that age, gender, MELD score, and Milan criteria had no effect on recurrence. Microvascular invasion (MVI) was detected in 55 patients (52\%), and 51 patients (48\%) had no MVI. The presence of MVI had a negative effect on tumor recurrence, and there was a statistically significant difference (p<0.001). There was also a significant difference in tumor recurrence between patients who had AFP levels under 400 IU/mL and those who had AFP levels above 400 IU/mL (p<0.001). Discussion: AFP level and the presence of MVI are significantly useful for predicting recurrence-free survival in patients with HCC following liver transplantation.