Hepatocellular carcinoma is a common indication for liver transplantation.
Currently, deceased donor liver transplantation is approved by the United Network for Organ Sharing for patients with Hepatocellular carcinoma.
These patients meet the Milan criteria of a single tumor up to 5 cm or up to 3 tumors up to 3 cm as determined by imaging studies.
|Patients with single tumors of 5 cm had 85% survival at 1 year|
Dr Gary Davis and collegues from Texas analyzed data in the International Registry of Hepatic Tumors in Liver Transplantation.
The research team evaluated data from 1206 patients with hepatocellular carcinoma in this registry.
The researchers determined tumor size and number by gross pathologic examination.
Kaplan-Meier recurrence-free survival in patients with a single tumor 5 cm or 2 to 3 lesions all 3 cm in diameter was 85% at 1 year.
The team found that recurrence-free survival with a 5 cm tumor or 2 to 3 lesions of 3 cm in diameter was 62% at 5 years.
The researchers noted that overall, patients whose tumors exceeded these limits had worse survival.
In patients with larger tumors, recurrence-free survival was 67% at 1 year and 43% at 5 years.
However, the team observed that not all patients in that group did poorly.
Patients with 2 to 4 tumors of 5 cm or single lesions of 6 cm had similar survival as with single tumors of 3 to 5 cm or 2 to 3 lesions of 3 cm.
Dr Davis' team concluded, "These data suggest that current criteria for selecting tumor patients for liver transplantation may be too restrictive and could be expanded."