Dr Island and colleagues from Massachusetts retrospectively reviewed prospectively collected data in a cohort of 92 patients.
The patients underwent liver transplantation for hepatocellular carcinoma between 1983 and 2003 in a tertiary referral center.
The team’s main outcome measures were patient demographics, tumor stage in the explant liver, patient survival, and tumor recurrence data.
The researchers reported that the average follow-up was 1052 days.
The investigative team noted that the average tumor size was 4 cm and that 40 % of tumors were multifocal and with 60 % being unifocal.
| Improvements in staging increase the 5 year survival rate to 69 %|
|Archives of Surgery|
The team also reported that of the 92 patients, 26 % were classified as stage I, 42 % as stage II, 24 % as stage III, and 8 % as stage IV.
The researchers found that the overall 5 year survival rate was 50 %, the 10 year survival rate was 32 %, and the 15 year survival rate was 27 %.
The team also observed that improvements in staging in the last 5 years reduced the number of patients with stages III and IV from 39 % to 19 %.
In addition, improvements in staging in the last 5 years were shown to increase the 5 year survival rate to 69 %.
The investigators indicated that tumor recurrence was relatively rare, however, recurrence resulted in a poor prognosis, with an average time to recurrence of 458 days.
Dr Island’s team concludes, “Liver transplantation for hepatocellular carcinoma results in excellent long-term survival for patients with stages I and II, with relatively few patients dying from tumor recurrence.”
“Improvements in preoperative staging have resulted in increased 5 year survival rates.”
“Further refinements in pre-liver transplantation staging may increase its effectiveness hepatocellular carcinoma.”