TABLE I.
Demographics and Clinicopathologic Features of All Patients Undergoing Transplantation versus Resection for HCC
| Total (n = 257), n (% total) |
OLT pts (n = 131), n (% group) |
Resection pts (n = 126), n (% group) |
P-Value | |
|---|---|---|---|---|
| Demographics | ||||
| Gender | ||||
| Male | 183 (71.2%) | 102 (77.9%) | 81 (64.3%) | 0.02 |
| Race | ||||
| White | 166 (64.6%) | 100 (76.3%) | 66 (52.4%) | <0.001 |
| Black | 47 (18.3) | 17 (13.0) | 30 (23.8) | |
| Other | 44 (17.1) | 14 (10.7) | 30 (23.8) | |
| Age, median [range], years | 59.0 [20.3–89.8] | 57.0 [38.9–73.3] | 61.5 [20.3–89.8] | 0.02 |
| ASA class | ||||
| 2 | 26 (10.1%) | 26 (20.6%) | <0.001 | |
| 3 | 86 (33.5) | 86 (68.2) | ||
| 4 | 145 (56.4) | 131 (100%) | 14 (11.1) | |
| Hepatitis B | 66 (25.7) | 45 (34.4) | 21 (16.7) | 0.002 |
| Hepatitis C | 123 (47.9) | 87 (66.4) | 36 (28.6) | <0.001 |
| Alcoholic cirrhosis | 55 (21.4) | 36 (27.5) | 19 (15.1) | 0.03 |
| Preoperative labs, median [range] | ||||
| Platelet (×103/μl) | 107 [11–747] | 54 [11–171] | 223 [54–747] | <0.001 |
| Albumin (gm/dl) | 3.2 [1.4–4.8] | 2.9 [1.4–4.1] | 3.5 [1.6–4.8] | <0.001 |
| Total bilirubin (mg/dl) | 1.1 [0.1–16.9] | 2.8 [0.5–16.9] | 0.7 [0.1–8.4] | <0.001 |
| INR | 1.16 [0.86–5.13] | 1.41 [0.93–5.13] | 1.03 [0.86–1.50] | <0.001 |
| Creatinine (mg/dl) | 0.90 [0.40–5.50] | 1.00 [0.46–5.50] | 0.90 [0.40–4.95] | 0.03 |
| AFP | 19 [0–38000] | 13.5 [0–2400] | 34 [1–38000] | 0.02 |
| Raw MELD score | 10 [6–39] | 15 [6–39] | 8 [6–23] | <0.001 |
| Patients within Milan Criteria | 176 (68.5%) | 131 (100%) | 45 (35.7%) | <0.001 |
| Child-Pugh Class | ||||
| Class A | 145 (56.4%) | 37 (28.2%) | 108 (85.7%) | <0.001 |
| Class B | 93 (36.2) | 75 (57.3) | 18 (14.3) | |
| Class C | 19 (7.4) | 19 (14.5) | 0 | |
| Pathology | ||||
| Number of lesions | ||||
| Unifocal | 176 (68.5%) | 73 (55.7%) | 103 (81.7%) | <0.001 |
| Multifocal | 81 (31.5) | 58 (44.3) | 23 (18.3) | |
| Largest tumor size (cm) | 3.7 [0.8–29.0] | 2.5 [0.8–6.0] | 7.0 [1.5–29.0] | <0.001 |
| Differentiation | ||||
| Well/moderate | 227 (87.5%) | 122 (93.1%) | 103 (81.7%) | 0.01 |
| Poor | 32 (12.5) | 9 (6.9) | 23 (18.3) | |
| Macrovascular invasion | 20 (7.8) | 7 (5.3) | 13 (10.3) | 0.21 |
| Microvascular invasion | 78 (30.4) | 23 (17.6) | 55 (43.7) | <0.001 |
| Cirrhosis/fibrosis present | 204 (79.4) | 131 (100) | 73 (57.9) | <0.001 |
| Outcomes | ||||
| 30 day mortality | 12 (4.6%) | 2 (1.5%) | 10 (7.9%) | 0.02 |
| Recurrence, any | 80 (30.9) | 14 (10.7) | 66 (52.4) | <0.001 |
| Intrahepatic recurrence | 62 (23.9) | 11 (8.4) | 51 (41.8) | <0.001 |
| Extrahepatic recurrence | 30 (11.6) | 6 (4.6) | 24 (19.0) | <0.001 |
HCC, hepatocellular carcinoma; OLT, orthotopic liver transplantation; ASA, American Society of Anesthesiology; INR, International Normalized Ratio; AFP, alpha fetoprotein; MELD, Model for End-Stage Liver Disease.