Clinical analysis of patients diagnosed with hepatocellular carcinoma recurrence after liver transplantation on a reference center in Espírito Santo

Abstract

Introduction: Hepatocellular carcinoma (HCC) is responsible for about 90% of liver cancer cases, being the most common histological type. Liver transplantation is the main therapy recommended for HCC, however, the lack of organs, together with the increase in the number of patients who are eligible for this choice of treatment, are factors that lead to a need of careful selection of liver recipients. Recurrence of post-transplant HCC is a systemic disease that has a drastic impact on patient survival. It is also known that its approach is still a little-known and very challenging field, thus, the study of predictors of this occurrence is being increasingly explored. Aim: Analyze the clinical-epidemiological profile of patients who presented recurrence after liver transplantation as curative therapy for HCC, within the Milan criteria, in the liver transplant service located at Hospital Meridional in Cariacica – ES. Methods: Retrospective, cross-sectional, descriptive study of the occurrences of HCC recurrence after liver transplantation between 2007 and 2020 with data collected from the review of medical records provided by the liver transplant service located at Hospital Meridional in Cariacica - ES. Results: The incidence rate of post-HT recurrence in this study was 12.7% in 13 years. The average age at transplant was 57 years and the average waiting time was 5 months. The 8 patients met the Milan Criterion at the time of transplantation, and 4 had to be previously submitted to “down-staging”. The mean of the AFP dosages obtained at the time of HCC diagnosis was approximately 270. The AFP dosage at the diagnosis of relapse showed a pattern of high values, averaging approximately 2311 ng/mg. The average time from transplant to recurrence was 17 months. The sites of recurrence were varied, with lung and liver being the most frequent. The percentage of death was 62.5%. Conclusions: In the present study, the profile of patients with post-HT HCC recurrence agrees, for the most part, with the national and world standard, reinforcing the importance of some recurrence predictors that are still in the study phase.