Liver transplantation for recurrence of primary liver cancer after resection

Abstract

Objective To study the indication and treatment of liver transplantation for the patients with recurrence after resection of liver cancer. Methods The clinical data of 7 patients with recurrence after tumor resection of primary liver cancer receiving liver transplantation between Sep. 2000 and Scp. 2005 were analyzed retrospectively. Among them, 6 cases were male and 1 female with the average age of 43.7 years old. Before liver transplantation, primary liver cancer was proven by pathology and the histological types of tumors were well and middle differentiated. The tumor free interval after partial hepatectomy for primary liver cancer was 6-31 months. There were no large vasculature invasion by tumor and extrahepatic metastasis before liver transplantation. All the patients received modified piggy-back liver transplantation and were subjected to immunosuppressive therapy of tacroli mus (or sirolimus) + mycophenolate mofetil + steroid. The complication and survival rate after liver transplantation was observed. The experience of liver transplantation for recurrence of primary liver cancer after resection was analyzed. Results There was no perioperative death in 7 patients. The main complications after operation included abdominal hemorrhage (1 case) at 22 h, abdominal infection (1 case) on the 13th day and portal vein thrombosis (1 case) on the 4th month. Three patients were died of tumor recurrence at 9th, 13th and 19th month after liver transplantation. Up to now, the remaining patients survived and had no recurrence, and the longest survival time was 52 months. In the 7 patients, 1- and 2-year survival rate was 85.7%(6/7) and 57.1%(4/7), respectively. Conclusion Liver transplantation is an effective therapy for the patients with recurrence after resection of liver cancer. The selection of the indications and the adjuvant therapy during operation are very important. Key words: Liver Neoplasms; Hepatectomy; Recurrence; Liver transplantation