Hepatocellular Carcinoma in Unrelated Viral Cirrhosis: Long-Term Results After Liver Transplantation

• Published in: Transplantation proceedings 2010-05, Vol.42 (4), p.1212-1215
• Main Authors: Lauterio, A, Di Sandro, S, Slim, A, Giacomoni, A, Mangoni, I, Mihaylov, P, Pirotta, V, Aseni, P, De Carlis, L
• Format: Article
• Language: English
• Subjects: Adult; Aged; Biological and medical sciences; Cadaver; Carcinoma, Hepatocellular - pathology; Carcinoma, Hepatocellular - surgery; Disease-Free Survival; Female; Follow-Up Studies; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Gastroenterology. Liver. Pancreas. Abdomen; Hepatitis B - complications; Hepatitis B - surgery; Hepatitis C - complications; Hepatitis C - surgery; Humans; Liver Neoplasms - pathology; Liver Neoplasms - surgery; Liver Transplantation - mortality; Liver Transplantation - physiology; Liver, biliary tract, pancreas, portal circulation, spleen; Liver. Biliary tract. Portal circulation. Exocrine pancreas; Living Donors; Male; Medical sciences; Middle Aged; Recurrence; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system; Survivors; Time Factors; Tissue Donors; Tissue, organ and graft immunology; Tumors
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2010.03.127

Abstract Introduction Chronic viral hepatitis is considered to be the most significant risk factor for development of hepatocellular carcinoma (HCC). Nevertheless, about 5%–15% of HCC occur in noncirrhotic or virus-unrelated cirrhotic patients. The natural history of HCC in terms of incidence, clinical features, and tumor progression differs according to the underlying cancerogenic factors and differences in hepatocarcinogenetic pathways. Little is know about the relationship between HCC outcomes after liver transplantation (OLT) and the primary liver disease. We retrospectively analyzed the outcomes of patients transplanted due to HCC in settings of either virus—related or virus-unrelated cirrhosis. Patients and Methods From January 2000 to December 2007, 179 patients underwent OLT due to HCC: 157 (87.8%) affected by virus-related (group A) and 22 (12.2%) virus-unrelated cirrhosis (group B). We analyzed patient characteristics including demographics, tumor features, downstaging treatments, and recurrences. Results At a mean follow-up of 41.2 months, the 3- and 5-year overall long-term survivals between group A versus group B were 81% versus 75% and 85% versus 78.4% respectively ( P = NS). The 3- and 5-year disease-free survivals between group A versus group B were 90.8% versus 89.6% and 85.6% versus 85.6%, respectively ( P = NS). After OLT, HCC recurrences occurred in 14 group A (14/157, 8.9%) and 4 patients (4/22, 18.1%) group B subjects. Discussion Our data demonstrated that after OLT, HCC outcomes were not different between patients with virus-related or -unrelated cirrhosis. The direct oncogenetic role played by hepatitis B and C appear to not be associated with a greater risk to develop HCC recurrence.