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

• DOI: 10.1016/j.transproceed.2005.09.169
• Publication Date: 2005-12-29T07:13:10Z
• Authors: B. Pérez Saborido; J.C. Menéu Dı́az; S. Jiménez de los...; C. Loinaz Segurola; M. Abradelo de Usera; M. Donat Garrido; A. Moreno Elola-O...; R. Gómez Sánz; C. Jiménez Romero; I. Garcı́a Garcı́a; E. Moreno González
• Keywords: Adult; Male; Carcinoma, Hepatocellular; Time Factors; Adolescent; Patient Selection; Biopsy, Fine-Needle; Liver Neoplasms; Middle Aged; Survival Analysis; Liver Transplantation; 3. Good health; 03 medical and health sciences; Treatment Outcome; 0302 clinical medicine; Recurrence; Preoperative Care; Humans; Female; Neoplasm Invasiveness; Aged; Follow-Up Studies; Retrospective Studies

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.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%).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.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.