[P-81] PREDICTORS OF TUMOR RECURRENCE IN LIVER TRANSPLANTATION FOR HCC.

Ivaylo Mitsiev, Ahmed Fahmy, Vincent Peyregne, Devon John, Thomas Diflo, Glyn Morgan, Lewis Teperman Organ Transplantation Center, NYU Medical Center, New York, NY, USA

BACKGROUND: The preferred treatment for hepatocellular carcinoma (HCC) in cirrhosis is liver transplantation. Since the introduction of the MELD system and inclusion of Milan criteria, many efforts have been made to evaluate the prognostic criteria affecting outcome. The aim of this study is to assess the preoperative factors that might impact tumor recurrence and patient survival.
METHOD: From February 2003 to November 2008, 143 patients underwent liver transplantation for HCC in our center. The following clinical pre-transplant variables were compared to tumor recurrence rate and patient outcome: tumor number and size, TNM staging, Milan criteria, pre-operative level of alpha-fetoprotein (AFP), MELD score and recipient age. The data was evaluated using ANOVA univariate analysis.
RESULTS: The recurrence rate was 10% after a median follow up of 20.2 months. The preoperative AFP level and tumor number were found to correlate significantly with patient survival (p=0.001). The Milan (p=0.002) and TNM-Stage (p=0.003) showed a statistically significant correlation with outcome. The Milan criteria (p<0.001) and the TNM-Stage (p=0.002) were the most powerful predictors of tumor recurrence. Tumor volume (p=0.006) and tumor number (p=0.015) also showed a significant correlation. AFP (p=0.503) did not have a significant impact on tumor recurrence. Patient age and MELD score were not found to be statistically significant in predicting outcome or recurrence.
CONCLUSION: The TNM-Stage and Milan criteria are reliable predictors of patient survival after liver transplantation for HCC. All preoperative radiologic findings demonstrated significant correlation with rate of tumor recurrence. MELD score, serum AFP and recipient age could not be used to predict tumor recurrence. Further study will be necessary to evaluate other parameters that may predict patient survival and tumor recurrence.

Date: Wednesday, July 8, 2009
Session Info: Poster Session I (5:30 PM-7:00 PM)
Presentation Time: 5:30 PM
Room: Americas Hall I, Level 3