篇名 | Risk Factors for Early and Late Recurrence in Hepatocellular Carcinoma after Liver Transplantation |
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卷期 | 41:6 |
作者 | Fan Hsiu‑Lung 、 Hsieh Chung‑Bao 、 Kuo Shih‑Ming 、 Chen Teng‑Wei |
頁次 | 273-279 |
關鍵字 | Hepatocellular carcinoma 、 risk factors 、 liver transplantation 、 recurrence 、 MEDLINE 、 Scopus |
出刊日期 | 202112 |
DOI | 10.4103/jmedsci.jmedsci_160_20 |
Background: Risk factors of early and late recurrence in hepatocellular carcinoma (HCC) after liver transplantation (LT) remain unclear. Aim: To identify factors that affect, both early and late recurrence in this setting. Methods: We retrospectively analyzed outcomes of 220 patients with HCC who received LT. Two patients who underwent re‑transplantation were excluded. Early, late, and very late recurrence were defined as recurrence in the 1st year, 1–5 years, and >5 years after LT, respectively. Kaplan–Meier survival curves were generated, and log‑rank tests were performed to compare survival between these groups. Univariate and multivariate Cox proportional‑hazard models for risks of early and late recurrence were established. Results: Twenty and 19 patients experienced HCC recurrence in the 1st year and between 1 and 5 years, respectively, after undergoing LT. The groups differed significantly in cumulative postrecurrence survival rate. The hazard ratio of early recurrence for tumor size >3 cm was 1.766 (P = 0.046) and that for tumor number >3 was 1.929 (P = 0.027). Alpha‑fetoprotein >20 ng/mL was a predictor of early recurrence in multivariate analysis (P = 0.077). The hazard ratio of late recurrence for HCC with microvascular invasion was 1.891 (P = 0.047). Conclusion: The recurrence rate of HCC was high in the 1st year after LT. Patients with early recurrence had a poorer survival rate than those with late recurrence. Tumor size >3 cm and tumor number >3 were risk factors of early recurrence. Microvascular invasion was a risk factor for late recurrence. Close individual surveillance is needed in patients with these risk factors.