Liver transplantation for hepatocellular carcinoma in patients who do not meet the Milan criteria

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Suh, Kyung-Suk; Cho, Eung-Ho; Lee, Hae Won; Shin, Woo Young; Yi, Nam-Joon; Lee, Kuhn Uk
Issue Date
Dig Dis 2007;25:329-333
Carcinoma, Hepatocellular/*mortality/pathology/*surgeryDisease-Free SurvivalLiver Neoplasms/*mortality/pathology/*surgery*Liver TransplantationNeoplasm InvasivenessPersonnel SelectionPrognosisSurvival Analysisalpha-Fetoproteins/analysis
BACKGROUND: To expand the Milan criteria, prognostic factors other than size and number of tumor may be necessary. We analyzed outcome and prognostic factors in patients with hepatocellular carcinoma (HCC) exceeding Milan criteria to select favorable group of patients. METHODS: Between November 1997 and December 2005, 104 cases of liver transplantation for patients with HCC were performed at our center. Twenty-four patients did not meet the Milan criteria preoperatively. Among these 24 patients, 19 had no major vascular invasion at the time of surgery. We analyzed the survival and prognostic factors of these 19 patients. The mean follow-up period was 33 months (range 6-89). RESULTS: Three-year survival rate in 19 patients was 67.4%. Three-year survival rates were significantly higher when preoperative alpha-fetoprotein was less than 400 ng/ml (86.2 vs. 0%, p<0.001) when Edmonson-Steiner's histological grade 1 or 2 (100 vs. 40%, p = 0.036) and when microvascular invasion was absent (78.6 vs. 30%, p = 0.039). CONCLUSION: If vascular invasion is absent in preoperative radiological studies, and the preoperative alpha-fetoprotein is less than 400 ng/ml, our findings suggest a good prognosis after liver transplantation for HCC patients who do not meet the Milan criteria.
1421-9875 (Electronic)
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College of Medicine/School of Medicine (의과대학/대학원)Surgery (외과학전공)Journal Papers (저널논문_외과학전공)
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