engleski

Risk factors of hepatocellular carcinoma recurrence after liver transplantation

INTRODUCTION Hepatocellular carcinoma (HCC) is the fastest growing indication for liver transplantation (LT) worldwide.1 The expected five-year survival rates of LT for HCC meeting conventional Milan criteria are 65%–80% and they are influenced by tumor recurrence.2 AIM The aim of the study was to analyze risk factors for HCC recurrence and 5-year rate survival in patients who underwent LT for HCC. T MATERIALS AND METHODS his retrospective study included 198 patients who underwent LT for HCC between 2006 and 2018 in University hospital Merkur. Pre- and post- transplant data was tested using univariate analysis (UA) and multivariate analysis (MA) to assess variables influencing HCC recurrence and 5- year survival rate. RESULTS The five-year HCC recurrence rate was 11%. After UA, risk factors for HCC recurrence were: HCC beyond Milan criteria (MC) based on surgical specimen (SS), more than 3 HCC lesions on SS, total tumor diameter >9cm, micro- and macro- vascular invasion of HCC. Following MA, only total tumor diameter > 9 cm remained independent risk factors for recurrence of HCC. The five-year survival rate was 81%. Median of follow up was 37 months. Based on UA, risk factors for 5-year mortality were: age >60 years, HCC beyond MC based on SS, more than 3 HCC lesions in SS, AFP >1000 ng/mL, micro- and macro- vascular invasion and recurrence of HCC. After MA, independent risk factors were age >60, more than 3 HCC lesions and recurrence of HCC (OR 1.07, 1.09 and 3.62, CI 95 %, respectively). CONCLUSION Patients after LT for HCC have good prognosis with more than 80% 5-year survival and 11% HCC recurrence rate. Total HCC diameter > 9 cm, measured on surgical specimen, is the only independent risk factors for the recurrence of HCC. Furthermore, recurrence of tumor is most significant risk factor for the 5- year mortality. Other risk morality factors are recipient age > 60 and more than 3 HCC lesions on surgical specimen.

hepatocellular carcinoma ; liver transplantation ; risk factors ; survival recurrence

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