Efficacy and feasibility of salvage liver transplantation for recurrent hepatocellular carcinoma after primary liver resection

doi:10.19538/j.cjps.issn1005-2208.2018.02.19

Abstract：Objective To evaluate efficacy and feasibility of salvage liver transplantation (SLT) for recurrent hepatocellular carcinoma (HCC) after primary liver resection(PLR),and to investigate the risk factors involved in relapse-free survival (RFS) of patients underwent SLT.Methods A retrospective analysis was performed on clinical data of 60 patients underwent SLT for recurrent HCC after PLR,from Jan.2007 to Dec.2011,in Surgery of Liver Transplant and Hepatopancrobiliary,The General Hospital of Chinese People's Armed Police Forces.The efficacy and feasibility of recipients was analyzed by RFS after SLT.The risk factors involved in RFS were detected by multivariate analysis,according to relapse again or not during 5-years follow-up.The impact of independent risk factors on RFS was evaluated by Log-rank(Mantel-Cox) analysis.Results All the patients were follow up for 3.7 (0.1 ～9.9)years.Twenty-eight of 60 patients (46.7％) had been detected intra-hepatic relapse again and/or distal metastasis during 5 years follow-up.The total 1-、3-、5-years RFS after SLT were 79.1％,64.6％,53.0％,respectively.The independent risk factors,attribute to relapse again or metastasis of HCC after SLT,were recurrent tumor beyond Milan criteria,serum AFP level more than 400 μg/L,and micro-vascular invasion.1-,3-and 5-years RFS influenced by 3 independent risk factors,which had been depreciated significantly(P ＜ 0.05),were 39.9％,28.5％,22.8％;56.8％,44.7％,36.5％;24.1％,16.1 and 16.1％,respectively.Conclusion The independent risk factors,involved RFS of SLT for recurrent HCC after PLR,were recurrent tumor beyond Milan criteria,serum AFP level more than 400 μtg/L,and micro-vascular invasion.SLT can be used as a salvage strategy for recurrent HCC after PLR,even can obtain satisfactory clinical RFS.