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et al. tumor recurrences were outside Milan criteria after There are certain limitations of this study as this are a
[6]
resection for HCV etiology so they may not be candidates retrospective analysis. We also recognize that the numbers of
for subsequent transplantation so primary transplant can be patients in the salvage transplantation group were relatively
a good option for HCV-related HCC. low and with just two recurrences in salvage transplant group,
statistical significance of the recurrence rate is weak. Another
We also analyzed prognostic factors affecting survival limitation is that we did not have complete pathological
and recurrence in both primary transplant and salvage details of prior liver resection specimens in salvage transplant
transplant groups. High pre-operative AFP levels were group as some of them were referred to us after resection; in
associated with high recurrence rates. Vibert et al. also addition, some patients underwent resection before 2002,
[15]
found pre-operative AFP as a significant prognostic factor and complete pathological analysis was not available.
for poor survival and recurrence. High MELD score, no
pre-transplant interferon therapy, salvage transplant and In conclusion transplantation for post-hepatectomy
no prior transarteral chemoembolization was associated recurrence for patients with HCC associated with HCV-related
with worse survival rates. In multivariate Cox regression, chronic liver disease seems to offer inferior overall survival
analysis salvage transplant and no prior transcatheter arterial rates than primary transplantation. However, results in the
chemoembolization were independent predictors of worse era of new anti-HCV drugs need to be evaluated further.
outcome. Shimoda et al. suggested that advanced tumor
[16]
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Hepatoma Research | Volume 1 | Issue 1 | April 15, 2015 39