Prognosis and related risk factors in patients with primary liver cancer after liver transplantation

Abstract

Objective To evaluate the prognosis and related risk factors in patients with primary liver cancer after liver transplantation. Methods We retrospectively analyzed the clinical data of 298 patients who underwent liver transplantation between January 2013 and December 2017 at Beijing Chaoyang Hospital of Capital Medical University. 121 patients with primary liver cancer on postoperative pathological diagnosis were included into this study. The patients included 108 males and 13 females, aged from 31 to 70 years, with an average of (52.7±8.7) years. The prognosis and the related risk factors on prognosis were analyzed. The survival curve was drawn by the Kaplan-Meier method, and the survival rate was compared by the log-rank test. Multivariate Cox regression was used to analyze the prognostic factors. Results Of the 121 patients who were enrolled in this study, 5 patients died during the perioperative period, making a perioperative mortality rate of 4.1% (5/121). The remaining 115 patients were followed up and the followed up rate was 95.0% (115/121). The overall 1-, 2- and 3-year survival rates were 81.0%, 74.6% and 70.2%, respectively. The median survival was 41.5 months. Multivariate analysis showed that preoperative Child grading (RR=3.028, 95% CI: 1.625~5.643) and microvascular invasion (RR=7.165, 95% CI: 2.237~22.951) were independent risk factors of prognosis. The worse the preoperative Child grading, the worse was the prognosis. The prognosis of patients with microvascular invasion was also poor. Conclusions The overall prognosis of patients with primary liver cancer after liver transplantation was good. Preoperative Child grading and pathological microvascular invasion were the main risk factors of prognosis after liver transplantation carried out for primary liver cancer. Key words: Liver transplantation; Liver neoplasms; Prognosis; Risk factor