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. 2022 Jun 30;6(8):539-546.
doi: 10.1002/jgh3.12783. eCollection 2022 Aug.

Long-term outcomes of living-donor liver transplantation, hepatic resection, and local therapy for hepatocellular carcinoma with three <3-cm nodules in a single institute

Masaaki Hidaka  1 , Takanobu Hara  1 , Akihiko Soyama  1 , Tomohiko Adachi  1 , Hajime Matsushima  1 , Takayuki Tanaka  1 , Hideki Ishimaru  2 , Hisamitsu Miyaaki  3 , Kazuhiko Nakao  3 , Susumu Eguchi  1
Affiliations

Long-term outcomes of living-donor liver transplantation, hepatic resection, and local therapy for hepatocellular carcinoma with three <3-cm nodules in a single institute

Masaaki Hidaka et al. JGH Open. .

Abstract

Background and aim: Treatment for small hepatocellular carcinoma (HCC) is determined based on the results of a liver function test and the tumor location and spread. The present study compared the outcomes among local therapy, hepatic resection (HR), and living-donor liver transplantation (LDLT) for small HCC in a single institute.

Methods: We compared the overall survival, recurrence-free survival, and cancer-specific survival rates in patients with three HCC nodules <3 cm in size among local therapy, which included radiofrequency ablation (RFA), percutaneous ethanol injection (PEI), and transarterial chemoembolization (TACE), and surgical treatment (HR and LDLT).

Results: One hundred and ninety-seven patients with local therapy (109 RFA, 26 PEI, and 78 TACE), 107 with HR, and 66 with LDLT were enrolled in this study. There was no significant difference in OS among these groups. The recurrence-free, cancer-specific survival (CSS) of LDLT was superior to local therapy and HR. The prognostic factors for the survival were Child-Pugh (CP) Grade B and tumor marker for local therapy and multiple tumors and elevated ALT levels for HR.

Conclusions: For CP grade B patients with HCC of three <3-cm nodule, LDLT could be considered because it resulted in better survival and CSS rates than local therapy.

Keywords: liver resection; locoregional therapy; small HCC; transplantation.

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Figures

Figure 1
Figure 1
(a) Comparison of the overall survival rate (N.S.). formula image, LDLT; formula image, HR; formula image, local. (b) Comparison of the recurrence‐free survival rate (P < 0.01). formula image, LDLT; formula image, HR; formula image, local. (c) Comparison of the cancer‐specific survival rate (P < 0.01) of hepatocellular carcinoma patients with three <3‐cm nodules among local therapy, hepatic resection (HR), and living‐donor liver transplantation (LDLT). formula image, LDLT; formula image, HR; formula image, local.
Figure 2
Figure 2
(a) Comparison of the overall survival rate (P = 0.03). formula image, LDLT; formula image, local. (b) comparison of the recurrence‐free survival rate (P < 0.01). formula image, LDLT; formula image, local. (c) comparison of the cancer‐specific survival rate (P < 0.01) of hepatocellular carcinoma patients with three <3‐cm nodules between local therapy and living‐donor liver transplantation (LDLT) in Child–Pugh grade B. formula image, LDLT; formula image, local.
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