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Updated: Jan 18, 2026
A Hepatocellular Cancer Patient-Derived Organoid Xenograft Model to Investigate Impact of Liver Regeneration on Tumor Growth
Published on: February 2, 2024
Post-recurrence Survival After Liver Transplantation for Hepatocellular Carcinoma
Marianna Maspero1,2, Carlo Sposito1,2, Chase Wehrle3
1General Surgery and Liver Transplantation Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy.
Background:
Mortality after liver transplantation (LT) for hepatocellular carcinoma (HCC) is mainly driven by HCC recurrence. We sought to determine whether post-recurrence survival (PRS) has improved during the last 2 decades.
Methods:
Using the Scientific Registry of Transplant Recipients, we included all patients who underwent LT for HCC between 2003 and 2020 and experienced HCC recurrence. Patients were divided into 4 eras (2003-2007, 2008-2012, 2013-2016, and 2017-2020) according to their year of recurrence.
Results:
Of 26 309 patients who underwent LT for HCC, 2518 patients were included: 276 (11%) in era 1; 662 (26.3%) in era 2; 685 (27.2%) in era 3; and 895 (35.5%) in era 4. Patients in later eras were more likely to be outside Milan, but within Metroticket 2.0, and underwent more bridging therapies. Median PRS was 9 mo (95% confidence interval [CI], 8-10 mo) for era 1, 13 (11-15) for era 2, 15 (13.5-16.5) for era 3, and 17 mo (15-19 mo) for era 4 ( P < 0.001). After adjusting for time to recurrence, only the comparison between era 1 and era 4 remained significant. At multivariable analysis, only time to recurrence <24 mo (hazard ratio, 1.4; 95% CI, 1.2-1.7; P < 0.0001) and poorly differentiated HCC (hazard ratio, 1.5; 95% CI, 1.2-1.8; P < 0.0001) were associated with PRS, while recurrence era was not.
Conclusions:
PRS has only modestly improved during the last 2 decades. Despite more patients undergoing bridging therapies in later eras, PRS has not changed compared with eras with more restrictive transplant criteria.
