Transplantation vs resection for hepatocellular carcinoma with compensated liver function after downstaging therapy

Table 1 Downstaging treatments n (%)

	LT group	LR group
Number of treatments	31	35
TACE only	15 (48.4)	18 (51.4)
One time	5	7
Two times	8	7
Three times	2	4
RAF only	7 (22.6)	10 (28.6)
One time	5	6
Two time	2	4
TACE + RAF	4 (12.9)	3 (8.6)
TACE + TACE + RAF	3 (9.7)	2 (5.7)
TACE + RAF + TACE	2 (6.5)	2 (5.7)

TACE: Transarterial chemo-embolization; RFA: Radiofrequency ablation; LT: Liver transplantation; LR: Liver resection.

Table 2 Baseline demographic and tumor characteristics in the two groups

	LT group (n = 31)	LR group (n = 35)	P value
Age (yr)	43.0 ± 8.2	45.5 ± 8.1	0.212
Gender (male:female)	20:11	20:15	0.544
Weight (kg)	68.6 ± 7.8	65.8 ± 10.6	0.241
Height (cm)	166.9 ± 8.6	164.6 ± 9.3	0.302
BMI (kg/m2)	22.8 ± 1.8	23.2 ± 2.4	0.404
Underlying liver disease			0.901
HBV	29	33
HCV	1	1
HBV and HCV	1	1
MELD score	8.6 ± 3.8	8.7 ± 4.7	0.866
Child score			0.617
A (5-6)	20	23
B (7-9)	11	12
C (≥ 10)	0	0
Serum creatinine (μmol/L)	71.3 ± 24.1	64.3 ± 20.9	0.212
Active lesion number (Pre-/Post-downstage)			0.672/0.721
One target	13/16	15/19
Two targets	10/9	14/11
Three targets	8/6	6/5
Total diameter of the tumors (cm)	6.8 ± 2.1/ 4.5 ± 1.7	6.7 ± 2.3/4.1 ± 1.9	0.786/0.376
AFP level (ng/mL)
Pre-downstage	1425.4 ± 1512.6	1332.9 ± 1122.5	0.777
Post-downstage	218.0 ± 244.0	248.6 ± 267.6	0.631
Tumor differentiation			0.960
Well	16	19
Moderate	7	6
Poor	8	10
Ishak score	4.6 ± 1.5	3.9 ± 1.3	0.069

LT: Liver transplantation; LR: Liver resection; HBV: Hepatitis B virus; HCV: Heptatitis C virus; AFP: Alpha-fetoprotein; BMI: Body mass index.

Table 3 Complications after liver transplantation or liver resection

Complications	LT group (n = 31)	LR group (n = 35)
Bile leakage	2 (Grade I, I)	1 (Grade I)
Intra-abdominal bleeding	2 (Grade I, V)	2 (Grade II, III)
Wound infection	2 (Grade I, I)	1 (Grade I)
Pleural effusion	1 (Grade III)	2 (Grade I, II)
Respiratory failure	2 (Grade IV, V)	1 (Grade V)
Ileus	1 (Grade II)	0
Hepatic artery thrombosis	1 (Grade II)	0
Subphrenic abscess	1 (Grade III)	1 (Grade III)
Liver failure	1 (Grade V)	0
Rejection	2 (Grade II, V)	0

Grade I: Treated conservatively without any drugs; Grade II: Treated with pharmacology; Grade III: Intervention with anesthesia; Grade IV: Organ dysfunction; Grade V: Death. LT: Liver transplantation; LR: Liver resection.

Table 4 Risk factors for tumor recurrence in the two groups

Factors	Odds	95%CI	P value
Tumor differentiation	2.225	1.365-3.882	0.041
Post-downstaging AFP level > 400 ng/mL	2.113	1.971-3.104	0.015

AFP: Alpha-fetoprotein.