EXPERIENCE OF ORTHOTOPIC LIVER-TRANSPLANTATION AND HEPATIC RESECTION FOR HEPATOCELLULAR-CARCINOMA OF LESS-THAN 8 CM IN PATIENTS WITH CIRRHOSIS

Fifteen patients with cirrhosis underwent orthotopic liver transplanta tion for small hepatocellular carcinoma (HCC) and 12 patients with cir rhosis underwent hepatic resection for similar HCC. Ah tumours were of the non-fibrolamellar variant. The majority of the patients in the tr ansplant group had Child's grade B or C cirrhosis. Median follow-up wa s 37 months with a minimum of 18 months. Eleven of 12 patients in the resection group had Child's grade A cirrhosis. Median follow-up was 29 months with a minimum of 16 months. Actuarial survival rates at 1 and 3 years for the transplanted patients were 80 and 63 per cent and all were tumour free. Tumour recurrence rate was 15 per cent. The overall 1- and 3-year tumour-free survival rates for patients in the resectio n group were 61 and 33 per cent. Tumour recurrence rate was 45 per cen t. The results show orthotopic liver transplantation to be an importan t surgical option in cirrhotic patients with small HCC, particularly i n those with moderate to severe hepatic decompensation.