Indications and results of hepatic transplantation for cancer
From April 1978 to 1st October 1990, 19 patients underwent liver transplantation for primary or secondary cancer of the liver. Eleven patients were transplanted for hepatocellular carcinoma secondary to cirrhosis, generally alcoholic (9 cases), hepatitis B (1 case) or secondary to haemochromatosis (1 cas). Three patients developed hepatocellular carcinoma in a normal liver, including one fibrolamellar cancer and three a proximal bile duct cancer. Lastly, two patients received a graft for secondary cancer from a colonic adenocarcinoma and a carcinoid tumour of the right colon. The operative mortality was nil for the transplantations for cancer in a normal liver, but there were 4 deaths out of the 11 cases of cancer secondary to cirrhosis. The actuarial survival of the overall series was 55% at 1 year and 31% at 2 years. The poorest survival was observed for cancers in a normal liver, with the exception of the fibrolamellar cancer in which recurrence was delayed. The longest survival was observed for cancers secondary to cirrhosis. At three years, the results of liver transplantation were equal to those of hepatic resections with a survival of 37%, despite the fact that the transplantation was generally performed for very large tumours.