Effects of Risk Factors and Ki-67 on Rates of Recurrence on Patients Who Have Undergone Liver Transplant for Hepatocellular Carcinoma

Purpose. We investigated the prognostic factors affecting recurrence including Ki-67 among patients who underwent liver transplantation for hepatocellular carcinoma. Materials and Methods. The 50 patients with a diagnosis of hepatocellular carcinoma and cirrhosis included those with expanded criteria for hepatocellular carcinoma excluding subjects with major vascular invasion and metastases but not taking into account tumor size and number of tumor nodules. Results. Twenty-eight patients had hepatocellular carcinoma characteristics outside the Milan criteria. Nineteen patients had unifocal; 31, multifocal hepatocellular carcinomas. Mean tumor size was 3.2 cm; mean tumor number was 5.06 lesions. Over a mean follow-up of 45.3 +/- 22.6 months, we diagnosed, respectively 2 recurrences. Overall 1-, 3-, and 5-year patient survival rates were 95.6%, 88.4%, and 84.8% and disease-free survival rates, 92%, 78.4%, and 71%, respectively. The independent prognostic factors by multivariate analyses were the number of tumors and Ki-67 with a cutoff value of 10%. Conclusion. Ki-67 staining percentage represent a marker to select recipients and to follow posttransplant recurrence.