Recurrence of hepatocellular carcinoma after liver transplantation: recurrence characteristics and risk factors.

BACKGROUND/AIMS: The aim of this study was to investigate tumor recurrence characteristics of hepatocellular carcinoma (HCC) after liver transplantation (LT), including recurrence sites, time and risk factors, and to provide a basis for predicting and preventing tumor recurrence. METHODOLOGY: Data from 224 consecutive patients with HCC who underwent LT between Feb 1999 and December 2008 at our center had been retrospectively analyzed. Tumor-unrelated, perioperative and in hospital deaths were excluded (n = 39). All the cases were followed-up regularly. According to recurrence or not, the cases were divided into recurrence group (n = 103) and non-recurrence group (n = 99). The data were analyzed statistically. RESULTS: Extrahepatic and single site recurrences were more common in early postoperative days, especially in the lung. No significant relation was observed between recurrence sites and time. Exceeding Milan criteria (MC), macrovascular invasion, liver capsule invasion, satellite lesions and Tumor-Node-Metastasis (TNM) classification of UICC were observed significant different in univariate analysis. TNM classification and macrovascular invasion were considered 2 independent risk factors in multivariate analysis. Macrovascular invasion was a independent risk factor for very early recurrences (6 months). CONCLUSIONS: Recurrence of HCC after LT was not frequent at intrahepatic but extrahepatic sites. The recurrence time was mainly in early operative days. TNM classification and macrovascular invasion are risk factors. Macrovascular invasion is associated with early recurrence.