Predictive Factors for the Resectable Type of Hepatocellular Carcinoma Recurrence After Living Donor Liver Transplant |
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| Institution: | 1. Service urologie, Centre Hospitalier Universitaire, Angers, France;2. Service de chirurgie visceral, Centre Hospitalier, Le Mans, France;3. Service chirurgie vasculaire et thoracique, Centre Hospitalier Universitaire, Angers, France;4. Service de néphrologie, Centre Hospitalier Universitaire, Angers, France;1. General Surgery and Digestive System Department, Regional University Hospital of Málaga, Málaga, Spain;2. General Surgery and Digestive System Department, Clinic University Hospital of Málaga, Málaga, Spain;1. Department of Hepatobiliary Surgery, Clinical Medical College, Yangzhou University, Yangzhou 225001, China;2. Department of Hepatobiliary Surgery, The First Clinical College, Dalian Medical University, Dalian 116000, China;3. Department of Interventional Radiology, Clinical Medical College, Yangzhou University, Yangzhou 225001, China;1. Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan;2. Department of Surgery, Kyushu University Beppu Hospital, Beppu, Japan;1. Department of Pulmonology, Semmelweis University, Budapest, Hungary;2. Department of Internal Medicine and Oncology, Semmelweis University, Budapest, Hungary;3. Department of I. Pathology, Semmelweis University, Budapest, Hungary;4. Department of Thocacic Surgery Semmelweis University, Budapest, Hungary |
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| Abstract: | Recurrence of hepatocellular carcinoma (HCC) after living donor liver transplant (LDLT) is an essential factor defining prognosis, and surgical resection is the only curative treatment. However, the factors that define whether surgical resection is possible remain unclear. Here, we compared resectable and unresectable HCC recurrence cases after LDLT and examined factors that determine whether surgical resection is possible.Resectable (n = 17) and unresectable (n = 14) groups among 264 patients who underwent LDLT for HCC from January 1999 to March 2020 were compared and examined for recurrence type, prognosis, and clinicopathologic factors. Overall survival after LDLT (median, 8.5 vs 1.7 years, P < .01) was significantly longer in the resectable group. In univariate analysis, female recipient rate, lymphocyte to monocyte ratio (LMR) ≥2.75, and tumor size ≤5.0 cm were significantly higher in the resectable group. Younger donors, lower Model for End-Stage Liver Disease scores, lower graft volume, and lower graft volume to standard liver volume ratio were evident in the resectable group. In multivariate analysis, female recipient rate (P = .0034) and LMR ≥2.75 (P = .0203) were independent predictive factors for resectable HCC recurrence after LDLT. Female recipient and LMR ≥2.75 before transplant could predict the surgically resectable type of HCC recurrence after LDLT. |
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