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Recurrence of Hepatocellular Carcinoma After Liver Transplantation: Patterns and Prognostic Factors Based on Clinical and Radiologic Features

Young-sun Kim1, Hyo K. Lim1, Hyunchul Rhim1, Won Jae Lee1, Jae Won Joh2 and Cheol Keun Park3

1 Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Kangnam-gu, Seoul 135-710, Korea.
2 Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
3 Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.


Figure 1
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  		Fig. 1 —Graph shows Kaplan-Meier survival curve for recurrence of hepatocellular carcinoma after liver transplantation. One-, 3-, and 5-year cumulative recurrence-free survival rates are 91.4%, 82.1%, and 76.6%, respectively. + = censored data.

 

Figure 2
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  		Fig. 2A —53-year-old man with stable disease after radiation therapy for recurrent hepatocellular carcinoma after liver transplantation and with hepatitis B-related liver cirrhosis in Child-Pugh class B. Contrast-enhanced CT scans show 3-cm hepatocellular carcinoma (arrow, A) in right hepatic lobe with right intrahepatic portal vein invasion (arrowhead, B) managed with living-donor liver transplantation.

 

Figure 3
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  		Fig. 2B —53-year-old man with stable disease after radiation therapy for recurrent hepatocellular carcinoma after liver transplantation and with hepatitis B-related liver cirrhosis in Child-Pugh class B. Contrast-enhanced CT scans show 3-cm hepatocellular carcinoma (arrow, A) in right hepatic lobe with right intrahepatic portal vein invasion (arrowhead, B) managed with living-donor liver transplantation.

 

Figure 4
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  		Fig. 2C —53-year-old man with stable disease after radiation therapy for recurrent hepatocellular carcinoma after liver transplantation and with hepatitis B-related liver cirrhosis in Child-Pugh class B. Contrast-enhanced CT scan shows solitary recurrent tumor found in celiac lymph node (arrow) approximately 22 months after liver transplantation.

 

Figure 5
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  		Fig. 2D —53-year-old man with stable disease after radiation therapy for recurrent hepatocellular carcinoma after liver transplantation and with hepatitis B-related liver cirrhosis in Child-Pugh class B. Contrast-enhanced CT scan after radiation therapy shows considerable decrease in size of celiac lymph node (arrow). Patient survived in stable condition for 48.9 months after transplantation.

 

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