Adjuvant chemotherapy and radiotherapy in liver transplantation for primary hepatocellular carcinoma: a feasibility study

Despite considerable advances in knowledge of tumor biology and diagnosis, the overall prognosis of hepatocellular carcinoma remains poor. When possible, hepatic resection is the treatment of choice, but less than 30 % of HCCs can be considered for resection (Dusheiko 1992, Haug 1992, Ringe 1988). The experience with liver transplantation for hepatic malignancies is still limited, and the results are far to be impressive. Tumor recurrences are usual (43 to 60 %), liver and the lung being the 2 most commonly involved sites of relapse (Calne 1982, Iwatsuki 1991). In an attempt to reduce the high risk of relapse rate in patients with liver transplantation for HCC, we underwent a pilot study of a adjuvant treatment combining preoperative chemoembolization, preoperative radiotherapy and postoperative chemotherapy.