RECURRENCE AND THE SURVIVAL ANALYSIS OF LIVER TRANSPLANTED HEPATOCELLULAR CARCINOMA PATIENTS

Introduction: Hepatocellular carcinoma (HCC) still constitutes a major cause of mortality even after liver transplantation (LT). Since 5-30% HCC recurrence risk after liver transplantation is still a problem in these patients. We aimed to evaluate our LT indications and results for HCC. Patients and Methods: Between December 1988 and December 2019 we performed 648 LT at our centers. We developed our criteria for LT for HCC candidates; we performed LT in any of HCC patients without major vascular invasion and distant metastasis. From January 1998 to December 2018, 49 adult patients with diagnosis of HCC who underwent LT were included in this study. Clinical data on cancer demographics, recurrence patterns and survival outcomes were evaluated retrospectively. Results: 49 LT for HCC had a median age 55 years. HCC recurrence after LT were detected in 13 (26,5%) of them. The recurrences were intrahepatic in 2 patients and the rest were extrahepatic. Median overall survival was 64,3 months, however median survivals were significantly lower in the patients who had HCC recurrence; median survivals were 126,3 vs 43,4 months for non- recurrent vs recurrent groups respectively (p=0.024). In the expanded criteria group (n: 25) 7 patients (28%) had HCC recurrence during follow-up, whereas this ratio was 25% (n: 6 of 24 patients) in within Milan group. Median time for HCC recurrence were 11,7 vs 12,6 months in within Milan group vs expanded criteria group respectively and there was no significant difference in between groups according to the time to progression. Conclusion: Multidisciplinary treatment modalities will probably lead to prolonged survival in HCC patients. We also showed that liver transplantation indications for HCC patients can be safely and effectively expanded with promising results.