Abstract:

Objective To discuss the experience of diagnosis and treatment for the patients with recurrenthepatocellular carcinoma （HCC） long-term after liver transplantation. Methods The clinical data were retrospectively analyzed from 1 308 HCC patients who received liver transplantation from April 2001 to September 2018 in Liver Cancer Institute, Fudan University. Close laboratory examination and radiological follow-up wereperformed post-transplantation. Results There were 2 patients with metastasis of HCC 10 years after liver transplantation. The patients' condition was satisfactorily controlled by comprehensive treatment strategy and one patient got complete response. Conclusion LT is one of the radical treatments for HCC, however，tumor recurrence and metastasis remain the most important factors that affect the outcome of liver transplantation. Screening the recipients properly, selecting the sensitive factors which can accurately predict the prognosis after liver transplantation,offering effective intervention for patients at high risks of recurrence and providing individualized treatment after recurrence and metastasis may further improve the outcome of LT with HCC.

Key words: Hepatocellular carcinoma, Liver transplantation, Recurrence, Comprehensive treatment

摘要：

目的 探讨肝癌（hepatocellular carcinoma，HCC）肝移植患者术后远期复发的诊治经验。方法 回顾性分析复旦大学肝癌研究所 2001 年 4 月 ~ 2018 年 9 月施行的 1 308 例肝癌肝移植患者临床资料，术后给予密切的实验室以及影像学随访。结果 有 2 例患者在移植术后 10 年复发，通过综合治疗后病情稳定，1 例患者达到完全缓解。结论 肝移植是治疗肝癌的根治性手段之一，但术后肿瘤复发转移已成为影响其疗效的重要因素。合理选择病例、筛选预测肝癌肝移植预后的敏感指标、对高复发风险的受体进行积极干预以及复发转移后的个体化治疗将不断提高肝癌肝移植的疗效。

关键词: 肝细胞癌 , 肝移植 , 复发 , 综合治疗