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Antiviral prophylaxis and recurrence of hepatocellular carcinoma following liver transplantation in patients with hepatitis B. Transplant Proc 2007 Dec;39(10):3276-80

Date

12/20/2007

Pubmed ID

18089370

DOI

10.1016/j.transproceed.2007.07.085

Scopus ID

2-s2.0-37149027485   30 Citations

Abstract

BACKGROUND: Orthotopic liver transplantation (OLT) is a viable treatment option for patients with hepatitis B (HBV) and concomitant hepatocellular carcinoma (HCC). However, cancer recurrence following transplantation approaches 20%. This study sought to identify the clinical and pathological factors associated with post-OLT survival.

METHODS: Univariate and multivariate analyses considered the following variables: combination viral prophylaxis, HBV recurrence, tumor stage, vascular invasion, distribution, nodularity, pre- and post-OLT tumor size, pre-OLT alpha-fetoprotein (AFP), Milan and UCSF criteria, and Asian race.

RESULTS: Cumulatively, HCC recurrence-free survival was 77%, 62%, and 53% at 1, 3, and 5 years, respectively, and was significantly better in patients who were free of viral recurrence post-OLT. Similarly, patients treated with combination prophylaxis had a significantly lower mortality than those who were not.

CONCLUSIONS: Multivariate analysis revealed that AFP>500 ng/mL, presence of vascular invasion by explant, HBV recurrence, and combination prophylaxis were independent predictors of HCC recurrence-free survival.

Author List

Zimmerman MA, Ghobrial RM, Tong MJ, Hiatt JR, Cameron AM, Busuttil RW

Author

Michael A. Zimmerman MD, FACS Professor in the Surgery department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Analysis of Variance
Antiviral Agents
Carcinoma, Hepatocellular
Disease-Free Survival
Hepatitis B
Humans
Immunoglobulins
Lamivudine
Liver Neoplasms
Neoplasm Staging
Postoperative Complications
Recurrence
Retrospective Studies
Survival Analysis
Survivors
Time Factors
Virus Diseases
jenkins-FCD Prod-486 e3098984f26de787f5ecab75090d0a28e7f4f7c0