Limitation of non-transplant treatment and proper timing for liver transplantation in patients with hepatocellular carcinoma considering long-term survival

Abstract

In this study, we investigated the long-term survival of patients with hepatocellular carcinoma (HCC) after conventional treatment other than liver transplantation (LT) in our institute and discuss the limitation of non-transplant treatment for HCC and the proper indictors of LT in the recent comprehensive era. Between 2003 and 2016, 181 patients with HCC aged ≤70 years received active treatment including liver resection, radiofrequency ablation (RFA), and transcatheter arterial chemoembolization (TACE). We analyzed the factors associated with overall survival and proposed new priority for the indicators of LT in HCC patients according to the extracted factors by comparing the survival with 39 transplanted patients with HCC. Child-Turcotte-Pugh (CTP) score (HR: 1.276; 95% CI: 1.049-1.552, P=.015), and number of tumors (HR: 1.238; 95% CI: 1.112- 1.377, P