Adjuvant chemotherapy after orthotopic liver transplantation for advanced hepatocellular carcinoma

Objective To investigate the feasibility, reliability and therapeutic effectiveness of adjuvant chemotherapy for advanced hepatocellular carcinoma(HCC) after orthotopic liver transplantation(OLT). Methods The clinical data of adjuvant chemotherapy after OLT in 10 advanced HCC patients were studied retrospectively. FAP chemotherapy regimen was adopted calcium folinate (CF) 200 mg/m 2 and 5 Fluorouracil 500 mg/m 2 iv on D1 to D5, and doxorubicin 40 mg/m 2 , cisplatin 30 mg/m 2 iv on D1,with 28 days as a cycle. The opportune time of chemotherapy, chemotherapy regimen, synergistic action between cytotoxic agent and immunosuppressive agent on liver and kidney and side effects were preliminarily evaluated. Results 7/10 patients are surviving, with the longest survival of 32 months, and the shortest 9 months. Three patients died after operation, two at 13 months, one at 20 months after OLT, all died of metastasis. The incidence of one year survival was 9/9. During the period of chemotherapy, the side effects of adjuvant chemotherapy were moderate. Conclusion Chemotherapy which is able to prolong the life span of patients with advanced HCC after orthotopic liver transplantation is feasible and effiective, the side effects were mild. The choice of opportune time of chemotherapy might influence the outcome.