Accuracy of staging as a predictor for recurrence after liver transplantation for hepatocellular carcinoma.

摘要: Background. Tumor number, size, and macrovascular invasion (MacroVI) are the most widely used predictors of survival after liver transplantation (LT) for hepatocellular carcinoma (HCC). We analyzed all patients undergoing LT HCC at our center to establish accuracy preoperative clinical staging determine which have a higher probability being understaged. Methods. In all, 118 with confirmed from April 1991 October 2004 institution were reviewed. All monitored serial imaging every 3 months ensure their eligibility within Milan criteria. Understaging in was defined as evidence on explant pathology that criteria (TNM stage pT1 or pT2) had been exceeded. Results. Five-year DFS 78% recurrence rate 15% median follow-up 30 months. On pathology, 43% (51/118) exceeded worse (1 year, 95% vs. 87%; 87% 64%; P=0.03) compared those who met more likely characteristics ≥2 tumor nodules (P=0.005) growth >0.25 cm/month (P=0.02) pathologic findings vascular (P=0.001) bilobar tumors (P=0.002). Conclusions. Preoperative while waiting list frequently understages assessed by pathology. Recurrence often occurred Improving inclusion parameters will proper organ allocation acceptable outcomes LT.