Table 3.
Clinic-pathological data of patients with recurrent HCC
| Case 1 | Case 2 | Case 3 | Case 4 | Case 5 | Case 6 | Case 7 | |
|---|---|---|---|---|---|---|---|
| Age (years) | 47 | 49 | 56 | 60 | 54 | 47 | 56 |
| Child score | C | A | A | B | C | C | B |
| MELD score | 19 | 9 | 8 | 14 | 16 | 18 | 13 |
| AFP (u/ml) | 2230 | 3041 | 1050 | 4.2 | 3.8 | 450 | 1020 |
| No of tumors | 1 | >4 | >4 | 1 | 1 | 3 | >4 |
| Size (cm) | 5 | 2.5, 2, 1.5,1 | 3, 2, 1, 0.5,0.5 | 3 | 2 | 1.5, 1, 1, 0.5 | 4, 2, 1, 1, 0.5 |
| Site | Rt. lobe | Bilobar | Bilobar | Rt. Lobe | Rt. Lobe | Bilobar | Bilobar |
| Milan criteria | Within | Beyond | Beyond | Within | Within | Within | Beyond |
| UCSF criteria | Within | Beyond | Beyond | Within | Within | Within | Beyond |
| Preoperative ablative therapy | Alcohol injection | No | No | No | RFA | No | TACE and RFA |
| Blood transfusion (units) | 4 | 0 | 0 | 2 | 10 | 3 | 10 |
| Differentiation | Moderate | Moderate | Moderate | Moderate | Well ablated by RFA | Moderate | Moderate |
| Micrvascular invasion | Yes | Yes | Yes | No | No | No | Yes |
| Immunosuppressant | Tacrolimus | Tacrolimus | Sirolimus | Sirolimus | Tacrolimus | Tacrolimus | Tacrolimus |
| Postoperative complications | Bile leak and hematemesis | HAT and biliary stricture | Bile leak and stricture | Bile leak | Bile leak, incisional hernia | Renal impairment | |
| Site of recurrence | Lung, liver-omentum-mesentry, bone, nasal sinuses | Liver-omentum | Bone (Lt.humerus) | Bone (back bone) | Liver | Rt.suprarenal-liver-bone (Clivus, sphenoidal Lt.orbital) | Liver |
| Time of recurrence posttransplant (months) | 29, 33, 36, 40 | 17 | 20 | 20 | 22 | 21, 22, 26 | 11 |
| Management | Rt lower lung lobectomy, liver resection, esection and anastomosis of ileum, chemotherapy | Intraoperative RFA | Internal fixation of humerus, radiotherapy | Back bone fixation and radiotherapy | Nexavar | Rt.suprarenal excision, TACE, radiotherapy | Nexavar |
| Tumor free survival (year) | 2.3 | 1.4 | 1.7 | 1.7 | 1.8 | 1.7 | 0.9 |
| Total survival (year) | 4 (died) | 1.6 (died) | 2.6 (died) | 2.25 (died) | 3 (died) | 2.2 (alive) | 1.5 (alive) |
No number, kg kilogram, cm centimeter, SD standard deviation, UCSF University of California San Francisco criteria, AFP alfa-fetoprotein, ng nanogram, mL milli Leter, LT liver transplant, CIT cold ischemia time, WIT warm ischemia time, TOT total operative time, MELD model of end stage liver disease, TACE transarterial chemo-empolization, RFA radiofrequency ablation