First-line liver resection and salvage liver transplantation are increasing therapeutic strategies for patients with hepatocellular carcinoma and child a cirrhosis.

The present study focused on nine patients with hepatocellular carcinoma (HCC) associated with Child A liver cirrhosis undergoing first-line liver resection and salvage liver transplantation (SLT) for liver tumor recurrence.Forty-six patients with HCC underwent liver transplantation (OLT); 37 (80.5\%) were primary liver transplantations (PLTs) and 9 (19.5\%) were SLTs. All patients who underwent SLT received minor transabdominal liver resections.The posttransplant 1-, 3-, and 5-year overall survival rates for SLT (88.9\%, 88.9\%, and 88.9\%) were similar to those for PLT (78\%, 62.7\%, and 62.7\%). Four (10.8\%) patients in the PLT group had HCC recurrence, while there was zero recurrence in the SLT group. The 1-, 3-, 5-year disease-free survival rates for PLT (89\%, 74\%, and 74\%) were similar to those for SLT (100\%, 100\%, and 100\%). The 1-, 3-, 5-year disease-free survival rates after PLT were 89\%, 74\%, and 74\%, and after SLT were 100\%, 100\%, and 100\%, respectively. The operative mortality, intraperioperative bleeding, operative time, intensive care unit stay, in-hospital stay, and overall incidence of postoperative complications were similar in the two groups.In our experience, SLT for HCC is a feasible procedure with similar results in terms of overall survival, disease-free survival, and postoperative complications to those reported for patients who underwent PLT at our institute. An important role exists for SLT as shown by the fact that such a strategy has been used in the 20\% of the patients undergoing OLT for HCC.