Erschienen in:
17.03.2017 | Hepatobiliary Tumors
Expansion of Criteria for Liver Transplantation in Hepatocellular Carcinoma: Better Patient Selection or a Slippery Slope?
verfasst von:
Adam C. Yopp, MD, Jorge A. Marrero, MD, Amit G. Singal, MD
Erschienen in:
Annals of Surgical Oncology
|
Ausgabe 7/2017
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Excerpt
Hepatocellular carcinoma (HCC) is the third leading cause of cancer-related deaths worldwide and one of the leading causes of death in patients with cirrhosis.
1 In appropriately selected patients, orthotopic liver transplantation (OLT) provides 5-year overall survival rates approaching 70% and is the only therapy that offers both a cure for the cancer and the underlying liver cirrhosis. Prior to publication of the Milan criteria by Mazzaferro et al. in 1996, early results of OLT for HCC were dismal due to the high rate of recurrence and poor overall outcome. Adherence to the Milan criteria, a solitary tumor ≤5 cm or with three or less tumors each ≤3 cm with no evidence of vascular invasion or extrahepatic metastasis, has led to excellent post-transplant survival and forms the framework to award priority for deceased donor allocation in the US utilizing the model for end-stage liver disease (MELD) score.
2 …