A Preliminary Predictive Model of Post - Transplant Tumor Recurrence in Hepatitis B Virus Associated Hepatocellular Carcinoma - Epidemiological and Therapeutic Implications

Abstract

Background: Hepatocellular carcinoma (HCC) is one of the most aggressive malignancies worldwide with hepatitis B virus (HBV) as the most important etiological agent. Unfortunately, the outcome of medical management of HBV related HCC is abysmal and post-transplant tumor recurrence represents a major challenge. However, a robust clinical predictor of disease recurrence in HBV mediated HCC is yet to be established despite several evidences illustrating multiple causative factors. Aim: Here we report a preliminary model that predicted the probability of post-transplant tumor recurrence in patients presenting with HBV related HCC and opting for living donor liver transplantation (LDLT). Methods: Our study prospectively recruited 67 quantitative HBV DNA positive HCC patients and 71 quantitative HBV DNA negative HCC patients, all with documented evidences of chronic HBV infection. A linear model analysis based on minimum Akaike's Information Criterion (AIC) values was computed. This generated a statistical inference about the causal relationship between different pre-and post-transplant clinicopathological variables of the study population and