Tumour size is an important predictor for the outcome after liver transplantation for hepatocellular carcinoma

Aims: Recently, there is a tendency to expand tumour sizes qualifying for OLT. The present study re-evaluates tumour size and histopathological features as selection criteria for OLT. Methods: Retrospective analysis of 93 adult HCC patients underwent OLT between June 1985 and December 2003. Median follow-up was 28 months (1-222 months). The Milan criteria were routinely applied since 1994. Results: Five year survival rate of HCC patients was significantly lower than in patients transplanted for benign diseases, 41 and 71%, respectively (p < 0.0001). Multivariate analysis revealed that the presence of vascular invasion represents the most significant predictor (p < 0.001) affecting the survival rate. Survival was also significantly impaired when the tumour size was > 5 cm (p < 0.05), whereas the number of nodules had no significant effect on survival. Consequently, the survival rate for HCC fulfilling the Milan criteria histologically improved to 70% since 1994. Conclusion: Tumour size has been shown to be the most important pre-operatively detectable predictor for patient survival after OLT. (c) 2005 Elsevier Ltd. All rights reserved.