Purpose
Liver Transplantation (LT) is the preferred treatment for selected patients with hepatocellular carcinoma (HCC).
However,
even after the introduction of selection criteria such as Milan Criteria (1),
HCC recurrence rate after LT has been estimated to be 8-15% (2,3).
Many investigators have reported on the spectrum of imaging findings and recurrence patterns of HCC after LT (2-4),
distinguishing different patterns on the basis of recurrence location (2) or timing (4).
The majority of tumor burden in recurrent HCC is typically in extrahepatic locations (2) and...
Methods and Materials
Patients.
Between October 2004 and November 2011,
a total of 183 consecutive patients with HCC underwent LT at our hospital.
Of them,
8 patients were excluded because of a short follow up period (≤2 months),
as a result of perioperative mortality.
The remaining 175 patients (151 men,
24 women),
who had a follow-up period longer than 2 months and had undergone dymanic-imaging evaluation at least 3 months before transplantation,
were included.
Table 1summarizes clinical characteristics of the included patients.
Pretransplantation Imaging.
The preoperative dynamic-imaging examination...
Results
Pretransplantation Imaging and Histopathology of the explanted liver.
Of the 175 patients who were included,
122 (69,7%) patients had evidence of viable tumor on imaging examination,
whereas 125 patients (71,4%) had evidence of viable tumor on histopathology.
Among the 53 patients who had no evidence of viable tumor at the imaging examination performed closest to LT,
a previous dynamic MDCT or MRI performed within 6 months to LT was available in 41 patients,
allowing the evaluation of the enhancement pattern.
On a total of 163...
Conclusion
In our population the tumor recurrence rate was 13,7%,
which is similar to the rates observed in other studies with comparable follow-up period and in which Milan selection criteria were adopted (3,4).
Extrahepatic recurrence was the most common recurrence pattern with respect to tumor location,
comparatively with other studies in which the focus was on the appearance of early recurrence (2,3).
Consistently with previous studies (4),
the median time to recurrence was 12,36 months and late recurrence was less common,
representing only 12,5% of cases....
References
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MRI findings of recurrent hepatocellular carcinoma after liver transplantation: preliminary results.
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Kim YS,
Lim HK,
Rhim H et al.
Recurrence of hepatocellular carcinoma after liver transplantation: patterns and prognostic factors based on clinical and radiologic features.
AJR Am J Roentgenol.
2007 Aug;189(2):352-8.
Chok...