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. 2011 Oct 7;17(37):4206-12.
doi: 10.3748/wjg.v17.i37.4206.

Comparison of Milan and UCSF criteria for liver transplantation to treat hepatocellular carcinoma

Tarkan Unek  1 , Sedat Karademir, Naciye Cigdem Arslan, Tufan Egeli, Gulsen Atasoy, Ozgul Sagol, Funda Obuz, Mesut Akarsu, Ibrahim Astarcioglu
Affiliations

Comparison of Milan and UCSF criteria for liver transplantation to treat hepatocellular carcinoma

Tarkan Unek et al. World J Gastroenterol. .

Abstract

Aim: To assess the validity of the Milan and University of California San Francisco (UCSF) criteria and examine the long-term outcome of orthotopic liver transplantation (OLT) in patients with hepatocellular carcinoma (HCC) in a single-center study.

Methods: This study is a retrospective review of prospectively collected data. Between 1998 and 2009, 56 of 356 OLTs were performed in patients with HCC. Based on pathological examination of liver explants, patients were retrospectively categorized into 3 grou-ps: Milan + (n = 34), Milan -/UCSF + (n = 7) and UCSF - (n = 14).

Results: Median follow-up period was 39.5 (1-124) mo. The 5-year overall survival rates in the Milan +, Milan -/UCSF + and UCSF-groups were 87.7%, 53.6% and 33.3%, respectively (P < 0.000). Within these groups, tumor recurrence was determined in 5.8%, 14.3% and 40% of patients, respectively (P < 0.011). Additionally, the presence of microvascular invasion within the explanted liver had a negative effect on the 5-year disease free survival (74.7% vs. 46.7%, P < 0.044).

Conclusion: The Milan criteria are reliable in the selection of suitable candidates for OLT for the treatment of HCC. For cases of OLT involving living donors, the UCSF criteria may be applied.

Keywords: Hepatobiliary pathology; Hepatobiliary radiology; Hepatobiliary surgery; Hepatocellular carcinoma; Liver malignancy; Liver transplantation; Living donor liver transplantation; Living related liver transplantation; Oncologic surgery; Survival; Transplant.

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Figures

Figure 1
Figure 1
Kaplan-Meier overall survival curves for Milan +, Milan -/UCSF + and UCSF-patients (post-orthotopic liver transplantation). UCSF: University of California San Francisco.
Figure 2
Figure 2
Kaplan-Meier disease-free survival curves for Milan +, Milan -/UCSF + and UCSF-patients (post-orthotopic liver transplantation). UCSF: University of California San Francisco.
Figure 3
Figure 3
Kaplan-Meier overall survival curves for patients with microvascular invasion (post-orthotopic liver transplantation).
Figure 4
Figure 4
Kaplan-Meier disease-free survival curves for patients with microvascular invasion (post-orthotopic liver transplantation).
Figure 5
Figure 5
Kaplan-Meier overall survival curves for Milan +, Milan -/UCSF + and UCSF-patients based on pre-orthotopic liver transplantation imaging results. UCSF: University of California San Francisco. OLT: Orthotopic liver transplantation.
See this image and copyright information in PMC

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