Expansion of the hepatocellular carcinoma Milan criteria in liver transplantation: Future directions

Table 3 Prospective studies of downstaging of hepatocellular carcinoma before liver transplantation

Ref.	Criteria	Downstagingsuccess rate (%)	LT rate(%)	Survival,time and rate (%)	HCC recurrence (%)
Roayaie et al[11], 2002	Mount Sinai protocol		53.75	5 yr OS (44) 5 yr DFS (48) 5 yr DFS, tumors < 7 cm (55)
Yao et al[72], 2015	Beyond Milan: single tumor ≤ 8 cm, 2–3 tumors (at least one > 3 and ≤ 5 cm, total diameter ≤ 8 cm), 4–5 tumors each ≤ 3 cm and total diameter ≤ 8 cm	To MC: 65.3	54.2	5 yr OS (77.8) 5 yr I-to-T (56.1)	7.8
Bologna criteria - Ravaioli et al[35], 2008	Beyond Milan: 1 lesion ≤ 6 cm, 2 lesions ≤ 5 cm, 3–5 lesions ≤ 4 cm and total diameter ≤ 12 cm	To MC: 72.9	66.7	3 yr DFS (71) 3 yr I-to-T (56.3)	18.8
Millonig et al[73], 2007	UCSF	RECIST	84.8	5 yr CR (66.6); PR (63.7); NR (25)	25
Graziadei et al[37], 2003	Beyond Milan, no upper limit	Partial response (> 50% of tumor size)	66.6	4 yr OS (41); 5 yr I-to-T (31)	30

CR: Complete response; HCC: Hepatocellular carcinoma; I-to-T: Intention-to-treat; LT: Liver transplantation; NR: No response; PR: Partial response; UCSF: University of California San Francisco.