The value of serum alpha-fetoprotein in predicting tumor recurrence after liver transplantation for hepatocellular carcinoma.

Background: Many patients with hepatocellular carcinoma (HCC) who undergo liver transplantation (LT) subsequently develop tumor recurrence; this is the main factor affecting long-term survival after LT. Factors associated with tumor recurrence should be determined to improve the outcome of LT. The purpose of the study was to evaluate the value of alpha-fetoprotein (AFP) in forecasting tumor recurrence after LT for patients with HCC.
Methods: AFP data before and after LT for 97 patients with HCC who underwent LT in our center were analyzed retrospectively.
Results: The mean follow-up time was 17.1 +/- 2.1 months for all 97 patients, overall tumor recurrence rate was 32.9% (32/97), and mean recurrence time was 7.2 +/- 3.2 months. The most common tumor recurrence sites were liver, lung, skeleton, and other sites. Pre-transplant AFP levels >400 ng/ml were associated with higher tumor recurrence. Post-transplant AFP levels not decreasing to <or=20 ng/ml within 2 months were also indicative of higher risk of recurrence.
Conclusions: Pre-transplant AFP and the dynamic change of AFP after LT were valuable in predicting tumor recurrence after LT for patients with HCC.