[Influence of tumor characteristics on the outcome of liver transplantation among patients with hepatocellular carcinoma].

OBJECTIVE:To identify the influence of tumor characteristics on the outcome of liver transplantation (LT) among patients with hepatocellular carcinoma (HCC). METHODS:A retrospective analysis was performed on 251 consecutive patients with HCC who underwent LT between April 2001 and February 2006 at our institution. We compared the outcome of the patients classified by different tumor related factors. Survival analysis was performed using Kaplan-Meier and Cox proportional hazards regression methods. RESULTS:Macroscopic vascular invasion, lymph node metastasis, Edmondson pathologic classification, microscopic tumor thrombosis, tumor location, satellite nodules and alpha-fetal protein (AFP) all significantly affected the overall survival and/or recurrence-free survival post-LT (P < 0.01 or P < 0.05). Pre-operative treatment and hepatitis background had no effect to the prognosis (P > 0.05). At multivariate Cox regression analysis, the factors associated with mortality or recurrence were macroscopic vascular invasion, microscopic tumor thrombosis and satellite nodules (P < 0.01 or P < 0.05). CONCLUSION:Edmondson grade III - IV, microscopic tumor thrombosis, left lobar or bilobar tumor, satellite nodules and AFP > or = 300 microg/L were predictive factors of poor prognosis. Presence of macroscopic vascular invasion or lymph node metastasis should be contraindicated.