Optimal treatment strategy and prognostic analysis of salvage liver transplantation for patients with early hepatocellular carcinoma recurrence after hepatectomy

Hao Chien Hung, Yin Lai, Jin Chiao Lee, Yu Chao Wang, Chih Hsien Cheng, Tsung Han Wu, Ting Jung Wu, Hong Shiue Chou, Kun Ming Chan, Wei Chen Lee, Chen Fang Lee*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

Abstract

Aim: We aimed to investigate the prognostic factors for salvage liver transplant in patients with early hepatocellular carcinoma recurrence after hepatectomy. Methods: This retrospective analysis included 53 patients who underwent salvage living-donor liver transplantation between January 2007 and January 2018. There were 24 and 29 patients in the early (recurrence ≤24 months after primary liver resection) and the late recurrence groups, respectively. Results: In the multivariate Cox regression model, pre-liver transplant downstaging therapy, early recurrence (ER) after primary liver resection, and recurrence-to-liver-transplant ≥12 months were independent risks to predict recurrent hepatocellular carcinoma recurrence after salvage living-donor liver transplantation. Compared with the late recurrence group, the ER group showed lower disease-free survival rates (p < 0.001); however, the overall survival rates did not differ between the two groups (p = 0.355). The 1-, 3-, and 5-year disease-free survival rates were 83.3%, 70.6%, and 66.2%, and 96.0%, 91.6%, and 91.6% in the early and late recurrence groups, respectively. When stratified by recurrence-to-liver transplant time and pre-liver transplant downstaging therapy in the ER group, disease-free survival and overall survival rates were significantly different. Conclusion: ER after primary liver resection with advanced tumor status and a longer period of recurrence-to-liver-transplant (≥12 months) have a negative impact on salvage liver transplant. Our findings provide novel recommendations for treatment strategies and eligibility for salvage liver transplant candidates.

Original languageEnglish
Pages (from-to)838-850
Number of pages13
JournalHepatology Research
Volume54
Issue number9
DOIs
StatePublished - 09 2024

Bibliographical note

Publisher Copyright:
© 2024 Japan Society of Hepatology.

Keywords

  • early recurrence
  • hepatocellular carcinoma
  • primary liver resection
  • salvage liver transplantation

Fingerprint

Dive into the research topics of 'Optimal treatment strategy and prognostic analysis of salvage liver transplantation for patients with early hepatocellular carcinoma recurrence after hepatectomy'. Together they form a unique fingerprint.

Cite this