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Hepatocellular carcinoma biology predicts survival outcome after liver transplantation in the USA

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Abstract

Purpose

The aim of this study is to evaluate the clinicopathologic prognostic factors of cancer-specific survival (CSS) in hepatocellular carcinoma (HCC) patients who underwent liver transplantation (LT) stratified by tumor size.

Methods

From the Surveillance, Epidemiology, and End Results (SEER) 18 registries (2004–2012), we retrieved data of 570 patients who underwent LT for a solitary primary HCC lesion ≤5 cm. A two multivariable Cox models were constructed to identify prognostic factors of CSS in a two different tumor sizes (2 cm cutoff).

Results

Out of 570 HCC patients (median age 57 years), 16% had microvascular invasion (MVI) and 12% had a poorly differentiated tumor. Male sex (odds ratio [OR] 2.6), tumor size >2 cm (OR 1.78), elevated AFP (OR 2.31), and poor tumor differentiation (OR 2.59) are significant predictors of MVI. With a median follow up of 41.5 months (range 1–107 months), the 5-year CSS rate was 90% in the absence of MVI compared to 75% in the presence of MVI (p<0.001). Multivariate models revealed that age ≥60 years (hazard ratio [HR] 2.08), MVI (HR 2.26), and poor tumor differentiation (HR 2.42), were significant risk factors of a dismal CSS with HCC size >2 cm, but not with HCC ≤2 cm.

Conclusions

Primary HCC tumor size ≤2 cm had an excellent prognosis after LT and was not affect by the presence of MVI or poor tumor differentiation.

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Authors and Affiliations

  1. Department of Internal Medicine, Faculty of Medicine, Suez Canal University, Ring Road, Ismailia, Egypt

    Mohamed Abd El-Fattah

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  1. Mohamed Abd El-Fattah
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Correspondence to Mohamed Abd El-Fattah.

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Funding

This study was not funded.

Conflict of interest

MA El-F declares that he has no conflict of interest.

Human informed consent

There were no human consents, as this study was a retrospective database report.

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Cite this article

El-Fattah, M.A. Hepatocellular carcinoma biology predicts survival outcome after liver transplantation in the USA. Indian J Gastroenterol 36, 117–125 (2017). https://doi.org/10.1007/s12664-017-0732-x

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  • DOI: https://doi.org/10.1007/s12664-017-0732-x

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