Liver Transplantation for Hepatocellular Carcinoma: Hangzhou Experiences

Zheng, Shusen; Xu, Xiao; Wu, Jian; Chen, Jun; Wang, Weilin; Zhang, Min; Liang, Tingbo; Wu, Liming

doi:10.1097/tp.0b013e31816b67e4

Cited by 427 publications

(411 citation statements)

References 21 publications

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“…The meta-analysis included 19 studies 2,15,16,19,26,33,35,39,40,42,46,48,[53][54][55]57,63,67,84 that used different methodologies to compare the overall survival of patients meeting the MC and patients exceeding the criteria at the time of the explant pathology examination; 3949 patients were also stratified by the graft origin (deceased or living donors).…”

Section: And Transplantation For Patients With Hcc Beyond Conventimentioning

confidence: 99%

Milan criteria in liver transplantation for hepatocellular carcinoma: An evidence-based analysis of 15 years of experience

Mazzaferro

Bhoori²,

Sposito³

et al. 2011

Liver Transpl

508

322

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Section: And Transplantation For Patients With Hcc Beyond Conventimentioning

confidence: 99%

Milan criteria in liver transplantation for hepatocellular carcinoma: An evidence-based analysis of 15 years of experience

Mazzaferro

Bhoori²,

Sposito³

et al. 2011

Liver Transpl

508

322

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“…Therefore, Yao et al [19] proposed their own set of criteria, permitting the listing of patients with somewhat larger-sized tumors. In Asia, several independent criteria have also been proposed, expanding indications without increasing the risk of HCC recurrence significantly [20][21][22][23][24][25] ( Table 1). Five-year survival rates were as high as 80% after transplantation using these criteria.…”

Section: Surgical Therapiesmentioning

confidence: 99%

Current management of hepatocellular carcinoma: An Eastern perspective

Yim¹

2015

WJG

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“…3 Recently, expandable Hangzhou criteria (HC) were established in China. 4 Without macrovascular invasion, the criteria contain either a total tumor diameter Յ 8 cm or a total tumor diameter Ͼ 8 cm (histopathological grade I or II) along with a preoperative alpha-fetoprotein level Յ 400 ng/mL. The outcome of the patients (all with hepatitis B virus infection) meeting such criteria is not different from those meeting the MC.…”

mentioning

confidence: 99%

Are the Hangzhou criteria adaptable to hepatocellular carcinoma patients for liver transplantation in Western countries?

et al. 2009

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TO THE EDITORS:We read with great interest the article by Silva et al. entitled "Expanded Criteria for Liver Transplantation in Patients with Cirrhosis and Hepatocellular Carcinoma," which appeared in a previous issue of Liver Transplantation. 1 The main aim of this study was to evaluate the survival rates and recurrence probabilities of a new proposal for criteria (up to 3 tumors, each no larger than 5 cm, and a cumulative tumor burden Յ 10 cm).Outcomes in patients who had tumors within and beyond the Milan criteria (MC) were compared. Among transplanted patients, the 5-year survival and recurrence rates were not different between the 2 groups.The authors are to be congratulated on finding that these expanded criteria did not result in a reduction of survival in comparison with patients who had tumors within the MC. However, the low tumor recurrence rate reported at 5 years is the main concern of this article. Hepatocellular carcinoma (HCC) patients are known to have recurrence after liver transplantation (LT), especially when the disease is advanced. Therefore, in the last decade, there was a worldwide trend of selecting only early-stage HCC patients for LT. In fact, the 1996 cornerstone study by Mazzaferro et al.,2 from which the MC were derived, albeit based on a relatively small number of patients, showed that the 4-year overall survival rate was 85% if the pretransplant tumor stage was early. However, with such criteria, only a few HCC patients are eligible for LT.In recent years, many transplant centers have explored the feasibility of expanding those criteria. Increasingly, there have been reports showing that the long-term outcome of patients following LT is the same regardless of whether the MC are followed or not. Recently, expandable Hangzhou criteria (HC) were established in China. 4 Without macrovascular invasion, the criteria contain either a total tumor diameter Յ 8 cm or a total tumor diameter Ͼ 8 cm (histopathological grade I or II) along with a preoperative alpha-fetoprotein level Յ 400 ng/mL. The outcome of the patients (all with hepatitis B virus infection) meeting such criteria is not different from those meeting the MC. Moreover, 37.5% of the HCC patients may benefit from LT.The purpose of this retrospective study was to investigate whether the Chinese expanded criteria could be used to select HCC patients for LT in Western countries. From 1997From to 2007 patients with a preoperative diagnosis of HCC underwent LT in Strasbourg. Survival and recurrence rates were compared between MC and HC.Preoperatively, 68 of 196 (34.6%) patients were outside the MC. No difference was observed between the 2 groups in age, gender, etiology, Child-Pugh and Model for End-Stage Liver Disease scores, type of preoperative management (transarterial chemoembolization, radio frequency ablation, and surgical resection), waiting time between diagnosis and transplantation, type of graft and transplantation, immunosuppression regimen, or comorbidities.The 1-, 3-, and 5-year survival rates of the transplanted HCC ...

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Liver Transplantation for Hepatocellular Carcinoma: Hangzhou Experiences

Abstract: The results of this study show a reliable and feasible candidates selection and prognostic criteria of LT in HCC patients.

Cited by 427 publications

References 21 publications

Milan criteria in liver transplantation for hepatocellular carcinoma: An evidence-based analysis of 15 years of experience

Milan criteria in liver transplantation for hepatocellular carcinoma: An evidence-based analysis of 15 years of experience

Current management of hepatocellular carcinoma: An Eastern perspective

Are the Hangzhou criteria adaptable to hepatocellular carcinoma patients for liver transplantation in Western countries?

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