Transplant Proc. 2005 Nov;37(9):3874-3877.


Does Preoperative Fine Needle Aspiration-Biopsy Produce Tumor Recurrence in
Patients Following Liver Transplantation for Hepatocellular Carcinoma?

Perez Saborido B, Meneu Diaz JC, Jimenez de Los Galanes S, Loinaz Segurola
C, Abradelo de Usera M, Donat Garrido M, Moreno Elola-Olaso A, Gomez Sanz R,
Jimenez Romero C, Garcia Garcia I, Moreno Gonzalez E.

General, Digestive and Abdominal Organs Transplantation Surgical Department,
12 de Octubre Hospital, Madrid, Spain.

INTRODUCTION: Liver transplantation (OLT) has been advocated for patients
with carcinoma hepatocellular (HCC). A preoperative biopsy (fine needle
aspiration biopsy) [FNA] facilitates preoperative diagnosis of adverse
pathological factors: vascular invasion or histologicalic differentiation.
But a biopsy may cause abdominal dissemination and be related to a higher
incidence of recurrence. PATIENTS AND METHODS: From April 1986 to December
2003, we performed 95 OLT for HCC. We divided them in two groups: group A
without FNA-biopsy (67.9%) and group B with FNA-biopsy (32.1%). RESULTS: We
obtained the diagnosis of HCC in only 15 patients (57.6%). In two patients
an OLT was avoided due to the presence of abdominal dissemination at the
time of transplant. Recurrence incidence was higher among group B patients
(5.9% vs 31.8%; P = .003) due to extrahepatic recurrence (2% vs 27.3%; P =
.003). No differences were observed in morbidity or mortality. The two
groups were homogeneous in epidemiological and pathological variables
except: sex distribution, Child status, AFP level, tumor size, and pTNM
stage. If we compare recurrence rates in the two groups attending to these
nonhomogeneous variables, it was significantly higher among patients with
tumors larger than 3 cm, pTNM I-III stage, Child B-C, AFP >200 ng/mL, and
males or females. CONCLUSIONS: Preoperative liver biopsy is associated with
a larger incidence of tumor recurrence, so we believe that it is not
necessary prior to an OLT for HCC.

PMID: 16386569 [PubMed - as supplied by publisher]




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