Abstract: Objective To investigate the risk factors affecting neoplasm recurrence and metastasis following liver transplantation
(LT) and liver resection (LR) in patients with hepatocellular carcinoma (HCC) meeting Milan criteria. Methods We
retrospectively analyzed the clinical data of 88 patients with HCC meeting Milan criteria undergoing LT or LR in Nanfang
Hospital between January, 2006 and December, 2011 and compared the survival rate and recurrence-free survival rate between
the two groups. Univariate analysis of 12 variables during peri-operative period was carried out to screen the risk factors
affecting neoplasm recurrence and metastasis. Results The LT group and HR group had similar 1-, 3-, and 5-year-survival
rates (P>0.05), but the LT group showed significantly higher 1-, 3-, and 5-year recurrence-free survival rates (P<0.05). The
recurrence rate was much lower in LT group than in LR group (P<0.05). Multivariate analysis identified gender, tumor size,
degree of pathological differentiation, and microvascular tumor embolism as independent risk factors affecting the
recurrence-free survival rate. Conclusions Patients with HCC meeting Milan criteria undergoing LT have longer long-term
recurrence-free survival. A male patient with a greater tumor size, microvascular tumor embolism, and poorly differentiated
carcinoma is more likely to develop neoplasm recurrence and metastasis following the surgery.