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Liver Transplantation Beyond Milan Criteria

Hepatocellular carcinoma (HCC) is one of the leading causes of cancer-related death worldwide, being the fifth most common cancer and the third most common cause of cancer-related mortality. The incidence of HCC has been rising in the USA over the last 20 years. Liver transplantation is an optimal t...

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Autores principales: Lingiah, Vivek A, Niazi, Mumtaz, Olivo, Raquel, Paterno, Flavio, Guarrera, James V, Pyrsopoulos, Nikolaos T
Formato: Online Artículo Texto
Lenguaje:English
Publicado: XIA & HE Publishing Inc. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7132012/
https://www.ncbi.nlm.nih.gov/pubmed/32274347
http://dx.doi.org/10.14218/JCTH.2019.00050
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author Lingiah, Vivek A
Niazi, Mumtaz
Olivo, Raquel
Paterno, Flavio
Guarrera, James V
Pyrsopoulos, Nikolaos T
author_facet Lingiah, Vivek A
Niazi, Mumtaz
Olivo, Raquel
Paterno, Flavio
Guarrera, James V
Pyrsopoulos, Nikolaos T
author_sort Lingiah, Vivek A
collection PubMed
description Hepatocellular carcinoma (HCC) is one of the leading causes of cancer-related death worldwide, being the fifth most common cancer and the third most common cause of cancer-related mortality. The incidence of HCC has been rising in the USA over the last 20 years. Liver transplantation is an optimal treatment option, as it eliminates HCC as well as the underlying liver disease. The Milan criteria (1 lesion greater than or equal to 2 cm and less than or equal to 5 cm, or up to 3 lesions, each greater than or equal to 1 cm and less than or equal to 3 cm) have been adopted by many transplant societies worldwide as the criteria to determine whether patients with HCC can move forward with liver transplantation. However, many believe that the Milan criteria may be too strict in regard to its size requirements for lesions. This has led to a number of expanded criteria for liver transplantation, concerning both overall size and number of lesions, as well as incorporation of other markers of tumor biology. Tumor markers, such as alpha-fetoprotein, can also be used to follow treatment of HCC and possibly exclude patients from transplant. HCC presenting beyond Milan criteria can also be down-staged with locoregional therapy. Monitoring response to locoregional therapy and longer wait times after locoregional therapy prior to transplant can serve as surrogate markers of tumor biology as well.
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spelling pubmed-71320122020-04-09 Liver Transplantation Beyond Milan Criteria Lingiah, Vivek A Niazi, Mumtaz Olivo, Raquel Paterno, Flavio Guarrera, James V Pyrsopoulos, Nikolaos T J Clin Transl Hepatol Review Article Hepatocellular carcinoma (HCC) is one of the leading causes of cancer-related death worldwide, being the fifth most common cancer and the third most common cause of cancer-related mortality. The incidence of HCC has been rising in the USA over the last 20 years. Liver transplantation is an optimal treatment option, as it eliminates HCC as well as the underlying liver disease. The Milan criteria (1 lesion greater than or equal to 2 cm and less than or equal to 5 cm, or up to 3 lesions, each greater than or equal to 1 cm and less than or equal to 3 cm) have been adopted by many transplant societies worldwide as the criteria to determine whether patients with HCC can move forward with liver transplantation. However, many believe that the Milan criteria may be too strict in regard to its size requirements for lesions. This has led to a number of expanded criteria for liver transplantation, concerning both overall size and number of lesions, as well as incorporation of other markers of tumor biology. Tumor markers, such as alpha-fetoprotein, can also be used to follow treatment of HCC and possibly exclude patients from transplant. HCC presenting beyond Milan criteria can also be down-staged with locoregional therapy. Monitoring response to locoregional therapy and longer wait times after locoregional therapy prior to transplant can serve as surrogate markers of tumor biology as well. XIA & HE Publishing Inc. 2020-03-30 2020-03-28 /pmc/articles/PMC7132012/ /pubmed/32274347 http://dx.doi.org/10.14218/JCTH.2019.00050 Text en © 2020 Authors. http://creativecommons.org/licenses/by-nc/4.0/ This article has been published under the terms of Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0), which permits noncommercial unrestricted use, distribution, and reproduction in any medium, provided that the following statement is provided. “This article has been published in Journal of Clinical and Translational Hepatology at DOI: 10.14218/JCTH.2019.00050 and can also be viewed on the Journal’s website at http://www.jcthnet.com”.
spellingShingle Review Article
Lingiah, Vivek A
Niazi, Mumtaz
Olivo, Raquel
Paterno, Flavio
Guarrera, James V
Pyrsopoulos, Nikolaos T
Liver Transplantation Beyond Milan Criteria
title Liver Transplantation Beyond Milan Criteria
title_full Liver Transplantation Beyond Milan Criteria
title_fullStr Liver Transplantation Beyond Milan Criteria
title_full_unstemmed Liver Transplantation Beyond Milan Criteria
title_short Liver Transplantation Beyond Milan Criteria
title_sort liver transplantation beyond milan criteria
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7132012/
https://www.ncbi.nlm.nih.gov/pubmed/32274347
http://dx.doi.org/10.14218/JCTH.2019.00050
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