Introduction: Liver transplantation(LT) has better outcomes even in patient with child A than LR because LT can overcome the tumor and background liver factors. We hypothesis that the according to the background liver and tumor biology, treatment option would be different.

Method: We reviewed patient data who received LR or LT in Seoul National university hospital. The patient was divided into two groups according to the platelet count which reflect the cirrhosis. We performed risk factor analysis using only preoperative risk factors. Platelet was used as a background liver factor(>100K=no or mild cirrhosis, 100K=moderate to severe cirrhosis) and AFP and tumor size and number is used as tumor characteristics.

Result: Total 663 and 210 patient was included in LR and LT group. We compared overall survival(OS) and recurrence free survival(RFS) between LR and LT group according to platelet count. Three factors were used which was significant in multivariate analysis, AFP >100, the number of tumor >1, the size of tumor > 5cm as a tumor factor. If no risk factors in platelet>100K group. RFS and OS were not different in both group. If one risk factors, OS was similar but RFS is higher in LT group. If 2 risk factors, OS is higher in LT group. In platelet <100K group, if no risk, OS was similar in both group. But if 1,2 risk factors, OS is higher in LT group.

Conclusion: If no or mild liver cirrhosis, LR can be performed even the patient have 1 risk factor. But when the patient with moderate to severe cirrhosis, resection can be performed without any risk factor. LT have to be considered in patient with 2 risk factors even the mild cirrhotic liver. And If the patient with moderate to severe cirrhosis, even the 1 risk factors, transplantation have to be considered.

CITATION INFORMATION: Yoon K., Lee K., Hong S., Cho J-.H., Lee J-.M., Yi N-.J., Suh K. Which Way to Go, Liver Resection or Liver Transplantation for Hepatocellular Carcinoma in Child A Liver Cirrhosis Am J Transplant. 2017;17 (suppl 3).

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