Development Of A Predictive Scoring System For Salvage Liver Transplantation In Recurrent Hepatocellular Carcinomapatients: Retrospective Study Of A Single Center Experience

Objective:This retrospective study is to develop a predictive scoring system for salvage liver transplantation (SLT) in recurrent hepatocellular carcinoma (HCC) patients.Summary Background Data:SLT after a primary hepatic resection is an effective treatment for recurrent HCC. Previous studies demonstrate that many factors relate to the survival of HCC patients received SLT but no exact criteria for it.Methods:This was a retrospective study involving 57 HCC patients who underwent SLT (data were obtained from January 2003 to December 2012). Based on the preoperative parameters, COX regression analysis was used to identify risk factors and create a predictive scoring system for estimating survival rates.Results:We developed a predictive model based on three independent preoperative parameters, including:largest tumor diameter (divided into three groups:<3 cm,3-8 cm and≥ 8 cm, P< 0.001, HR=4.761,95% CI:2.101-10.786), macrovascular invasion (absent or present, P=0.008, HR=3.150,95% CI:1.357-7.312) and time interval to recurrence after hepatic resection (>1 year vs.≤ 1 year, P=0.017, HR 2.913,95% CI:1.215-6.984). A scoring system integrating these risk factors was developed as new criteria. Using the criteria, the survival rates for the low-risk patients were significantly higher than that of high-risk patients (P<0.001).Conclusion:Based on the new criteria, we predict the risks of patients with recurrent HCC after SLT. The criteria could contribute to preoperative risk assessment and clinical strategies for SLT.