Recurrent hepatocellular carcinoma after liver transplantation: spectrum of CT findings and recurrence patterns.

PURPOSE

To correlate computed tomographic (CT) and serum tumor marker (alpha-fetoprotein [AFP] and des-gamma-carboxy-prothrombin [DGCP]) findings in recurrent hepatocellular carcinoma (HCC) after orthotopic liver transplantation (OLT).

MATERIALS AND METHODS

At retrospective review of the cases in 124 patients, CT findings were recorded by consensus of at least two nonblinded observers and compared with levels of AFP and DGCP.

RESULTS

In 35 patients (68 sites), CT depicted recurrent HCC (most frequently in lungs [n = 18] and liver allograft [n = 16]) in a single site in 19 patients (54%) and in more than one site in 16 patients (46%). No stage I or II HCC recurred after 18-78 months (mean recurrence, 39 months). Stage IVA HCC recurred four times as often as stage III HCC (P < .001). Abnormally high serum AFP and DGCP levels indicated 69% and 43%, respectively, in patients with recurrent disease.

CONCLUSION

HCC recurrence after OLT correlates with initial stage, and CT is more sensitive than serum tumor markers in its detection.