The Value of Serum α-Fetoprotein in Predicting Tumor Recurrence After Liver Transplantation for Hepatocellular Carcinoma

Background Many patients with hepatocellular carcinoma (HCC) who undergo liver transplantation (LT) subsequently develop tumor recurrence; this is the main factor affecting long-term survival after LT. Factors associated with tumor recurrence should be determined to improve the outcome of LT. The purpose of the study was to evaluate the value of alpha-fetoprotein (AFP) in forecasting tumor recurrence after LT for patients with HCC. Methods AFP data before and after LT for 97 patients with HCC who underwent LT in our center were analyzed retrospectively. Results The mean follow-up time was 17.1 +/- 2.1 months for all 97 patients, overall tumor recurrence rate was 32.9% (32/97), and mean recurrence time was 7.2 +/- 3.2 months. The most common tumor recurrence sites were liver, lung, skeleton, and other sites. Pre-transplant AFP levels >400 ng/ml were associated with higher tumor recurrence. Post-transplant AFP levels not decreasing to <= 20 ng/ml within 2 months were also indicative of higher risk of recurrence. Conclusions Pre-transplant AFP and the dynamic change of AFP after LT were valuable in predicting tumor recurrence after LT for patients with HCC.