Journal of Medical Sciences

ORIGINAL ARTICLE
Year
: 2021  |  Volume : 41  |  Issue : 6  |  Page : 273--279

Risk factors for early and late recurrence in hepatocellular carcinoma after liver transplantation


Fan Hsiu-Lung1, Hsieh Chung-Bao1, Kuo Shih-Ming2, Chen Teng-Wei1 
1 Department of Surgery, Division of General Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
2 Department of Surgery, Division of Pediatric Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan

Correspondence Address:
Dr. Chen Teng-Wei
Division of General Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei
Taiwan

Background: Risk factors of early and late recurrence in hepatocellular carcinoma (HCC) after liver transplantation (LT) remain unclear. Aim: To identify factors that affect, both early and late recurrence in this setting. Methods: We retrospectively analyzed outcomes of 220 patients with HCC who received LT. Two patients who underwent re-transplantation were excluded. Early, late, and very late recurrence were defined as recurrence in the 1st year, 1–5 years, and >5 years after LT, respectively. Kaplan–Meier survival curves were generated, and log-rank tests were performed to compare survival between these groups. Univariate and multivariate Cox proportional-hazard models for risks of early and late recurrence were established. Results: Twenty and 19 patients experienced HCC recurrence in the 1st year and between 1 and 5 years, respectively, after undergoing LT. The groups differed significantly in cumulative postrecurrence survival rate. The hazard ratio of early recurrence for tumor size >3 cm was 1.766 (P = 0.046) and that for tumor number >3 was 1.929 (P = 0.027). Alpha-fetoprotein >20 ng/mL was a predictor of early recurrence in multivariate analysis (P = 0.077). The hazard ratio of late recurrence for HCC with microvascular invasion was 1.891 (P = 0.047). Conclusion: The recurrence rate of HCC was high in the 1st year after LT. Patients with early recurrence had a poorer survival rate than those with late recurrence. Tumor size >3 cm and tumor number >3 were risk factors of early recurrence. Microvascular invasion was a risk factor for late recurrence. Close individual surveillance is needed in patients with these risk factors.


How to cite this article:
Hsiu-Lung F, Chung-Bao H, Shih-Ming K, Teng-Wei C. Risk factors for early and late recurrence in hepatocellular carcinoma after liver transplantation.J Med Sci 2021;41:273-279


How to cite this URL:
Hsiu-Lung F, Chung-Bao H, Shih-Ming K, Teng-Wei C. Risk factors for early and late recurrence in hepatocellular carcinoma after liver transplantation. J Med Sci [serial online] 2021 [cited 2021 Dec 8 ];41:273-279
Available from: https://www.jmedscindmc.com/article.asp?issn=1011-4564;year=2021;volume=41;issue=6;spage=273;epage=279;aulast=Hsiu-Lung;type=0