Salvage transplantation for post-resection recurrence in hepatocellular carcinoma associated with hepatitis C virus etiology: a feasible strategy?

Abstract

Aim: The aim was to analyze the feasibility of salvage liver transplant after liver resection in hepatocellular carcinoma (HCC) with hepatitis C virus (HCV) etiology.

Methods: All the patients diagnosed with HCC with HCV etiology who underwent living donor liver transplant from July 2002 to November 2012 were studied. Their recurrence rate, mortality, and prognostic factors were analyzed and compared between primary transplant and salvage transplant for up to 5 years post-transplant.

Results: One hundred and nine patients underwent a liver transplant for HCC associated with HCV etiology within the University of California, San Francisco criteria. Eighteen were post-hepatectomy salvage transplants and 91 were primary transplants. Median follow-up time was 31 months. One, 3 and 5 years overall survival rates were 76%, 76% and 65% in the salvage group, and 92%, 85% and 85% in primary transplant group respectively. The difference in overall survival rates was statistically significant (P = 0.031). However, recurrence-free survivals for 1, 3 and 5 years were 72%, 72% and 46% for salvage group, and 91%, 73% and 46% for primary transplant group; which were not statistically significant (P = 0.328).

Conclusion: Salvage transplantation for post-hepatectomy recurrence for patients with HCC associated with HCV-related chronic liver disease seems to offer inferior overall survival rates than primary transplantation.

Keywords

Hepatitis C virus / hepatocellular carcinoma / salvage transplantation

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