Correlation between prognosis and histopathologic factors in patients with hepatocellular carcinoma after liver transplantation: A multivariate analysis / 第二军医大学学报

ABSTRACT

Objective: To evaluate the effect of histopathologic factors in patients with hepatocellular carcinoma after liver transplantation(LT) on the prognosis of liver transplantation. Methods: The clinical data of 272 HCC patients, who had received liver transplantation, were retrospectively analyzed. The survival rates were analyzed using the actuarial life-table method. Multivariate and univariate COX proportional hazards model were used to investigate the correlation between histopathologic factors and survival time. Kaplan-Meier method was used to plot the curves of accumulative survival rates and Log-rank tests were used to compare the curve of the survival rates. Results: Univariate analysis using a COX model revealed that scores of model of endstage liver disease(MELD), alphafetoprotein, size of tumor, capsule invasion, Eggel's classification, Edmonson-Steiner grade, microvascular invasion, regional lymph node metastasis and TNM staging were significantly related to the prognosis of the patient after LT(P<0.05). Multivariate COX model analysis showed that alphafetoprotein(RR1.459, P=0.002), Eggel's classification(RR1.617, P=0.004), microvascular invasion(RR2.631, P<0.001) and MELD(RR 2.194, P = 0.011) are independent factors of patient prognosis. Conclusion: Alphafetoprotein, Eggel' s classification, microvascular invasion and MELD are the independent prognostic factors of HCC patients after LT. More attention should be paid to the influence of MELD on prognosis of HCC patients after LT.