A Clinical Analysis on Liver Transplantation for Hepatocellular Carcinomas

Park, Jea Hyun; Kim, Dong Goo; Choi, Sung Ho; Moon, In Sung; Lee, Myung Duk; Kim, In Chul

Abstract

BACKGROUND/AIMS: Currently, the role of liver transplantation in the treatment of hepatocellular carcinoma (HCC) with cirrhosis is controversial. What remain to be determined are the best treatment protocol and who are likely to have a good outcome after liver transplantation. METHODS: Twenty-five patients with hepatocellular carcinoma underwent liver transplantation between 1993 and 2001 at the Department of Surgery, Catholic University of Korea. The follow-up period was from one month to 51 months. The pathologic findings, the recurrence, and survival of the 25 cases were analyzed. RESULTS: Two patients had a tumor larger than 5 cm in diameter and three patient had above 3 nodules in number. Five patients had bilobar tumors. Vascular invasion was present in 11 patients (45.8%). Among the 25 patients, postsurgical TNM staging was stage III in 3 patients, stage IVA in 5 patients, and stage IVB in 1 patient. Number of high risk patients were 16 (64%). During follow-up, 23 of the 25 patients (92%) were alive and the number of disease-free survivals was 21 among the 23 patients (91.3%). CONCLUSIONS: According to our small experience, HCC can be a good indication of liver transplantation, especially in low risk patients and even in the recurrent cases. A long-term survival can be achieved by aggressive treatment. However, the best protocol remains to be determined, especially for the case with large tumors.