Multidisciplinary approach in hepatocellular carcinoma progression treatment after liver transplantation: the first experience in Russia
Aim. To improve treatment outcomes for patients with hepatocellular carcinoma progression after liver transplantation. Material and methods. Patients with hepatocellular carcinoma progression after liver transplantation (n = 30) were divided into two groups retrospectively. Group 1 included 20 patients who underwent specialized surgical and chemotherapeutic treatment, and group 2 included 10 patients who received palliative care in connection with the advanced of the cancer. Results. Tumor progression rate was ten times higher in patients with tumors that do not meet the Milan criteria (57.8% vs 5.7%, respectively). Early progression (within 24 months) after liver transplantation was occured in 19 (63.3%) patients. The median overall survival in patients with early and late progression was 17 and 74 months, respectively. Multiorgan metastases were found in 40% of patients. One-, three- and five-year overall survival in the group 1 and 2 were, respectively, 90%, 71%, 50% and 30% and 0%. The median overall survival in the group 1 and 2 was 37.8 and 12 months respectively. Conclusion. Tumor lesion volume is the determining risk factor for the hepatocellular cancer progression after transplantation. Late disease progression associated with better prognosis. Multidisciplinary approach in treatment of hepatocellular carcinoma progression after liver transplantation significantly improves overall survival.