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Comparison of survival and tumor recurrence rates in patients undergoing liver transplantation for hepatitis B ‐related hepatocellular carcinoma using M ilan, S hanghai F udan and H angzhou criteria
Author(s) -
Gao Ting,
Xia Qiang,
Qiu De Kai,
Feng Yi Yan,
Chi Jia Chang,
Wang Si Yue,
Xi Zhi Feng,
Zhang Jian Jun,
Xu Ning,
Chen Shi Yao,
Qiu Yu Lan,
Shen Li Wei,
Zhou Ting Ting,
Dong Xiao Jun,
Li Qi Gen,
Li Hai
Publication year - 2013
Publication title -
journal of digestive diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 51
eISSN - 1751-2980
pISSN - 1751-2972
DOI - 10.1111/1751-2980.12083
Subject(s) - medicine , hepatocellular carcinoma , milan criteria , liver transplantation , hepatitis b , gastroenterology , surgery , hepatectomy , overall survival , hepatitis , transplantation , resection
Objectives To assess the performance of the M ilan, S hanghai F udan and H angzhou criteria based on a preoperative evaluation in patients undergoing liver transplantation ( LT ) for hepatitis B ‐related hepatocellular carcinoma ( HCC ). Methods Using a prospectively collected database, the data of consecutive patients with hepatitis B ‐related HCC undergoing LT at the Department of Liver Surgery of Ren Ji Hospital, School of Medicine, Shanghai Jiaotong University from J anuary 2005 to D ecember 2009 were reviewed. Overall survival and tumor recurrence rates of patients fulfilling the M ilan, S hanghai F udan and H angzhou criteria were compared using log–rank test. Results Altogether 148 patients were enrolled in the study, among whom 88 fulfilled the M ilan criteria and 24 and 39 were beyond M ilan but within the S hanghai F udan or H angzhou criteria, respectively. After a median follow‐up of 44 months, survival rates did not differ among the three groups ( P = 0.8780). Recurrence rates were significantly higher for newly eligible patients by the S hanghai F udan or H angzhou criteria compared with those within the M ilan criteria. Conclusions The M ilan criteria should be used as the preferred criteria for the selection of hepatitis B ‐related HCC for LT. Considering the high tumor recurrence rates and donor scarcity, a moderate expansion of the Milan criteria must be performed cautiously until high‐quality clinical trials are conducted.