Objective: Hepatocellular carcinoma (HCC) is the only cancer where transplantation is effectively used as a treatment. The recurrence of HCC after transplant is reported to be around 13% in the literature. In this study, we aimed to evaluate the long-term results and treatment methods of patients who underwent liver transplantation due to HCC in our center.
Materials and Methods: Out of 760 liver transplants performed between 8 December 1988 and 1 April 2024 at our center, 80 were due to hepatocellular carcinoma. Patients were divided into two groups. The first group consisted of patients who met the Milan criteria (early diagnosis group), and the second group included those who were outside the Milan criteria but met the Başkent criteria (late diagnosis group). Postoperative levels of alpha-fetoprotein (AFP), imaging findings, time of recurrence, post-recurrence treatments, disease-free survival, and overall survival were retrospectively examined and recorded.
Findings: Of the 80 patients in our study, 23 (28%) were pediatric patients. Recurrence occurred in 7 patients (8.7%; 5 adults, 2 children). Six of the 7 patients with recurrence met the Başkent criteria, and one met the Milan criteria. Surgical, locoregional treatment, and chemotherapy were applied to the patients with recurrence. The average survival time for all patients was 158.4 ± 10 months. The average survival in the early diagnosis group was longer than that in the late diagnosis group. During follow-up, 16 patients were lost due to recurrence, distant metastasis, and other causes.
Conclusion: Patients who have undergone liver transplantation for hepatocellular cancer should be closely monitored for recurrence. The survival of patients with recurrence can be improved with surgery, locoregional treatments, and chemotherapy.