Liver transplantation for hepatocellular carcinoma: Are the Milan criteria still valid? |
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| Authors: | M.E. Schwartz F. D'Amico A. Vitale S. Emre U. Cillo |
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| Affiliation: | 1. Recanati–Miller Transplantation Institute, Mount Sinai School of Medicine, New York, NY, USA;2. Unità di Chirurgia Epatobiliare e Trapianto Epatico, Università di Padova, Italy;3. Chirurgia Oncologica, Istituto Oncologico Veneto (IOV), IRCCS, Padova, Italy |
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| Abstract: | Liver transplantation (LT) offers excellent results for candidates with hepatocellular carcinoma (HCC) selected according to the Milan criteria. A selection strategy exclusively based on the Milan criteria, however, maintains a dangerous risk of prognostic inaccuracy due to the intrinsic diagnostic limitations of imaging procedures and to the surrogate nature of size and number of tumors with respect to more direct markers of biological aggressiveness like tumor grade, and vascular invasion. Moreover, the use of Milan criteria as dropout criteria seems to overestimate the risk of tumor biological progression before LT. |
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| Keywords: | Liver transplantation Hepatocellular carcinoma Milan criteria |
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