Unek T, Karademir S, Arslan NC, Egeli T, Atasoy G, Sagol O, Obuz F, Akarsu M, Astarcioglu I. Comparison of Milan and UCSF criteria for liver transplantation to treat hepatocellular carcinoma. World J Gastroenterol 2011; 17(37): 4206-4212 [PMID: 22072852 DOI: 10.3748/wjg.v17.i37.4206]
Corresponding Author of This Article
Dr. Sedat Karademir, Department of General Surgery, Dokuz Eylul University, School of Medicine, Izmir 35340, Turkey. sedatkarademir@gmail.com
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Brief Article
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Tarkan Unek, Sedat Karademir, Naciye Cigdem Arslan, Tufan Egeli, Gulsen Atasoy, Ibrahim Astarcioglu, Department of General Surgery, Dokuz Eylul University, School of Medicine, Izmir 35340, Turkey
Ozgul Sagol, Department of Pathology, Dokuz Eylul University, School of Medicine, Izmir 35340, Turkey
Funda Obuz, Department of Radiology, Dokuz Eylul University, School of Medicine, Izmir 35340, Turkey
Mesut Akarsu, Department of Gastroenterology, Dokuz Eylul University, School of Medicine, Izmir 35340, Turkey
Author contributions: Unek T designed the research/study, analyzed the data, performed the study and wrote the paper; Karademir S designed the research/study, analyzed the data, performed the study and wrote the paper; Arslan NC performed the study, collected the data and wrote the paper; Egeli T collected the data; Atasoy G collected the data; Sagol O examined pathologic specimens; Obuz F collected the data; Akarsu M collected the data and performed the study; Astarcioglu I performed the study.
Correspondence to: Dr. Sedat Karademir, Department of General Surgery, Dokuz Eylul University, School of Medicine, Izmir 35340, Turkey. sedatkarademir@gmail.com
Telephone: +90-232-4122908 Fax: +90-232-2772666
Received: May 12, 2011 Revised: August 1, 2011 Accepted: August 8, 2011 Published online: October 7, 2011
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.
