The essential predictors of recurrence in patients with hepatocellularcarcinoma 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 com
mon and markedly reduces the long-term survival of patients with HCC. The present study focuses on determining the predictive factors affecting the recur
rence of HCC.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).Conclusion AFP level and the presence of MVI are significantly useful for predicting recurrence-free survival in patients with HCC following liver transplanta
tion.

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