Year 2022 / Volume 114 / Number 4
Original
Characteristics and outcome of incidental hepatocellular carcinoma after liver transplantation: a cohort study

219-225

DOI: 10.17235/reed.2021.7744/2020

Raquel Ríos León, Eugenia Sánchez Rodríguez, Antonio Martínez Ortega, Enrique Rodríguez de Santiago, Natalia Marcos Carrasco, Javier Graus Morales, Miguel Ángel Rodríguez Gandía, Jose Luis Lledó Navarro, Francisco Gea Rodríguez, Javier María Nuño Vázquez Garza, Agustín Albillos Martínez, Miguel García González,

Abstract
Introduction: despite advances in imaging diagnostic modalities, hepatocellular carcinoma is sometimes incidentally diagnosed on histological examination of the liver explant. The objectives of the study were: a) to compare the characteristics between incidental and known hepatocellular carcinoma; and b) to estimate survival and tumor recurrence after liver transplantation. Material and methods: a retrospective, single-center study was performed. The inclusion criteria were: a) cirrhotic patients, age ≥ 18 years; b) liver transplantation between 1998 and 2018; and c) hepatocellular carcinoma diagnosed via histopathologic examination of the explanted liver. Cholangiocarcinoma and patients with early retransplantation were excluded. Multivariate analysis was performed using binomial logistic regression to assess the factors associated with incidental hepatocellular carcinoma. Kaplan-Meier curves were plotted to explore the impact on overall survival and recurrence free survival. Results: two hundred and sixty-nine patients were enrolled. The prevalence of incidental hepatocellular carcinoma was 4.18 % (95 % CI: 2.89-6.01 %) of all liver transplants performed in cirrhotic patients. The median diameter of the main nodule was smaller in incidental hepatocellular carcinoma (20 vs 27 mm, p = 0.004), although they were more likely to be beyond the Up-to-Seven criteria on explant examination (22.2 % vs 7.5 %, p = 0.001), with no differences in any other histological features. No differences were found in overall survival rates (incidental 70.2 % vs 70.4 %, p = 0.87) or recurrence-free survival (incidental 100 % vs 83.8 %, p = 0.07) at five years. Conclusion: incidental hepatocellular carcinoma are smaller in size and are more frequently found to be beyond the Up-to-Seven criteria. However, no differences were found in overall survival rates or recurrence-free survival, although there was no tumor recurrence in the incidental hepatocellular carcinoma group.
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Ríos León R, Sánchez Rodríguez E, Martínez Ortega A, Rodríguez de Santiago E, Marcos Carrasco N, Graus Morales J, et all. Characteristics and outcome of incidental hepatocellular carcinoma after liver transplantation: a cohort study. 7744/2020


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Publication history

Received: 18/12/2020

Accepted: 23/02/2021

Online First: 18/03/2021

Published: 07/04/2022

Article revision time: 57 days

Article Online First time: 90 days

Article editing time: 475 days


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