Mullath A, Krishna M. Hepatocellular carcinoma – time to take the ticket. World J Gastrointest Surg 2019; 11(6): 287-295 [PMID: 31367276 DOI: 10.4240/wjgs.v11.i6.287]
Corresponding Author of This Article
Murali Krishna, DNB, MBBS, MD, Assistant Professor, Surgeon, Surgical Specialist, Department of Surgery, Military Hospital, Holta Camp, Palampur 176061, Himachal Pradesh, India. murali276@yahoo.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Jun 27, 2019; 11(6): 287-295 Published online Jun 27, 2019. doi: 10.4240/wjgs.v11.i6.287
Hepatocellular carcinoma – time to take the ticket
Anju Mullath, Murali Krishna
Anju Mullath, Department of Gastroenterology, Lakeshore Hospital and Research Centre, Kochi 682040, Kerala, India
Murali Krishna, Department of Surgery, Military Hospital, Palampur 176061, Himachal Pradesh, India
Author contributions: Mullath A and Krishna M contributed equally to this work; Mullath A came up with the idea and performed the literature search; Krishna M wrote the manuscript; All authors have read and approved the final manuscript.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Murali Krishna, DNB, MBBS, MD, Assistant Professor, Surgeon, Surgical Specialist, Department of Surgery, Military Hospital, Holta Camp, Palampur 176061, Himachal Pradesh, India. murali276@yahoo.com
Telephone: 91-841-1066008
Received: May 9, 2019 Peer-review started: May 10, 2019 First decision: May 31, 2019 Revised: June 13, 2019 Accepted: June 20, 2019 Article in press: June 21, 2019 Published online: June 27, 2019 Processing time: 49 Days and 14.6 Hours
Abstract
Hepatocellular carcinoma is one of the leading malignancies worldwide. Early detection of hepatocellular carcinoma and its management in the form of liver transplantation offers an attractive treatment option. The Milan criteria, proposed by Mazzaferro et al, have been the standard for selecting patients with hepatocellular carcinoma for transplantation. Recently, several studies have shown that even patients selected outside the Milan criteria can undergo transplantation with a relatively good outcome. This article examines the currently existing criteria other than the Milan criteria and also evaluates use of alpha-fetoprotein and positron emission tomography scans to predict the chance of recurrence.
Core tip: The Milan criteria have been used extensively worldwide to select patients with hepatocellular carcinoma for liver transplantation. Over the years, it has been questioned whether the Milan criteria are too restrictive and whether patients outside the Milan criteria could benefit from liver transplantation. Several other criteria have been proposed and validated, and latest is the hepatocellular carcinoma Metroticket concept. This minireview evaluates the various current criteria that exist for liver transplantation for hepatocellular carcinoma cases.
