LT is viewed as the optimal treatment for HCC as it treats both the tumor and the underlying liver disease. Potential curative therapies for HCC include hepatic resection (HR) and liver transplantation (LT). Advanced stage at diagnosis and poor underlying liver function present major challenges to treatment. Worldwide, there were 782,000 new cases in 2012 and HCC is the second leading cause of cancer-related mortality with 745,000 deaths. Hepatocellular carcinoma (HCC) is the most common primary malignancy of the liver. Perhaps patients who meet these criteria can safely undergo non-transplant therapy and donor livers can be allocated to patients with a greater need. HR/RFA patients with both MELD < 10 and APRI ≤ 0.5 had 3- and 5-year OS of 77.3% and 72.7%.Ĭonclusion: Patients with MELD < 10 and APRI ≤ 0.5 who undergo HR/RFA have survival approaching LT. The strongest predictors of survival after HR/RFA were MELD < 10 and APRI ≤ 0.5 (OR 4.25, 95% CI 1.63-11.08). Results: LT patients had 3- and 5-year OS of 82.6% and 73.9% compared to HR/RFA patients with 3- and 5-year OS of 40.8% and 33.8%. Overall survival (OS) and odds-ratios (OR) for survival after HR/RFA were calculated for MELD score, platelet count, creatinine, albumin, AST/platelet ratio index (APRI), international normalized ratio, and bilirubin. Methods: In a database of 1,050 HCC patients, the authors identified those with single HCC ≤ 3.0 cm, who underwent hepatic resection (HR, n = 16), radiofrequency ablation (RFA, n = 55), or LT ( n = 23) with 5-year follow-up. The authors sought to identify characteristics that predicted long-term survival after non-transplant therapies in patients with small HCC. Aim: Liver transplantation (LT) is the most effective treatment for long-term survival from hepatocellular carcinoma (HCC) however, insufficient donors limit therapy.
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