Abstract
Background : Liver transplantation is the usual treatment for hepatocellular carcinoma.Aim:To analyze the MELD score, waiting time and three month and one year survival for liver transplantation in cirrhotic patients affected by hepatocellular carcinoma or not. Methods : This was a retrospective, observational and analytical study of 93 patients submitted to liver transplantation. Results : There were 28 hepatocellular carcinoma and 65 non-hepatocellular carcinoma patients with no differences related to age and sex distribution. The main causes of cirrhosis on hepatocellular carcinoma were hepatitis C virus (57.1%) and hepatitis B virus (28.5%), more frequent than non-hepatocellular carcinoma patients, which presented 27.7% and 4.6% respectively. The physiological and exception MELD score on hepatocellular carcinoma were 11.9 and 22.3 points. On non-hepatocellular carcinoma, it was 19.4 points, higher than the physiological MELD and lower than the exception MELD on hepatocellular carcinoma. The waiting time for transplantation was 96.2 days for neoplasia, shorter than the waiting time for non-neoplasia patients, which was 165.6 days. Three month and one year survival were 85.7% and 78.6% for neoplasia patients, similar to non-neoplasia, which were 77% and 75.4%.Conclusion:Hepatocellular carcinoma patients presented lower physiological MELD score, higher exception MELD score and shorter waiting time for transplantation when compared to non-hepatocellular carcinoma patients. Three month and one year survival were the same between the groups.
Highlights
Hepatocellular carcinoma (HCC) is the third leading cause of death from neoplasia worldwide, affecting one million people, with about five hundred thousand deaths annually[1]
The causes of cirrhosis were: hepatitis C virus (28%), alcoholic hepatitis (17.2%), hepatitis B virus (9.7%), nonalcoholic steatohepatitis (7,5%), hepatitis C virus associated with alcoholic hepatitis (6.5%), cryptogenic cirrhosis (5.4%) and others (25.7%)
This study showed that this extra score turned MELD values higher than those observed on patients without HCC
Summary
Hepatocellular carcinoma (HCC) is the third leading cause of death from neoplasia worldwide, affecting one million people, with about five hundred thousand deaths annually[1]. Its incidence is increasing annually in Western countries due to the higher number of patients infected with hepatitis C and B, which are present in approximately 90% of cases[1,9,20]. 80% of HCC patients have concomitant cirrhosis[16,21]. Those with liver cirrhosis have a 20% chance of developing the tumor in five years[6]. This high association defines the population of cirrhotic patients as risky, which must be followed through periodic screening, allowing the early diagnosis of the tumor[24]. The functional hepatic reserve may not be enough to tolerate and compensate the removal of the hepatic parenchyma . 30,33 factors
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