Up-to-7 Criteria for Hepatocellular Carcinoma Liver Transplantation: A Retrospective Analysis of Experiences

Díaz, F.; Daga, J.A. Pérez; Pérez, B. Sánchez; Aguilar, José Luis Fernández; Casado, Custodia Montiel; Narváez, José Manuel Aranda; Muñóz, Miguel Ángel Suárez; López, Laura Romacho; Villalba, Julio Santoyo; Santoyo, Julio Santoyo

doi:10.1016/j.transproceed.2016.08.035

Cited by 6 publications

(3 citation statements)

References 8 publications

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“…Fifty-eight studies that compared the Milan criteria with other criteria were included in the study. Of these, 41 studies compared the Milan and UCSF criteria 33–45 , 47–51 , 53 , 55–60 , 63 , 64 , 67 , 68 , 70–73 , 76–79 , 83 , 85 , 86 , 90 , 16 studies compared the Milan and UPTS criteria 46 , 52 , 54 , 59 , 61 , 62 , 65 , 66 , 68 , 73 , 74 , 78 , 83 , 84 , 86 , 87 , seven studies compared the Milan and AFP criteria 69 , 75 , 80–82 , 87 , 88 , four studies compared the Milan and MT2 criteria 82 , 87–89 , one study compared the UPTS and MT2 criteria 87 , one study compared the UPTS and AFP criteria 87 , three studies compared the MT2 and AFP criteria 82 , 87 , 88 , and six studies compared the UCSF and UPTS criteria 59 , 68 , 73 , 78 , 83 , 86 .…”

Section: Resultsmentioning

confidence: 99%

Prognostic role of selection criteria for liver transplantation in patients with hepatocellular carcinoma: a network meta-analysis

et al. 2022

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Background Patients with hepatocellular carcinoma (HCC) are selected for transplantation if they have a low tumour burden and low risk of recurrence. The morphometric Milan criteria have been the cornerstone for patient selection, but dynamic morphological and biological tumour characteristics surfaced as an encouraging tool to refine the selection of patients with HCC and to support the expansion of the Milan criteria. The outcomes of the most prevalent models that select patients with HCC for liver transplantation were analysed in this study, which aimed to identify the selection model that offered the best recurrence-free and overall survival after transplantation. Methods Studies that compared Milan, University of California San Francisco (UCSF), up-to-seven (UPTS), alpha-fetoprotein (AFP), and MetroTicket 2.0 (MT2) models were included. One-year, 3-year, and 5-year recurrence-free and overall survival rates of patients selected for transplantation using different models were analysed. Results A total of 60 850 adult patients with HCC selected for liver transplantation using Milan, UCSF, UPTS, AFP, or MT2 criteria were included. Patients selected for transplantation using the MT2 model had the highest 1-, 3-, and 5-year recurrence-free survival. In addition, patients selected for transplantation using MT2 criteria had the best 1- and 3-year overall survival, whereas patients selected for transplantation using the Milan criteria had the best 5-year overall survival rates. Conclusion The MT2 model offered the best post-transplant outcomes in patients with HCC, highlighting the importance of considering tumour morphology and biology when selecting patients with HCC for liver transplantation.

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Section: Resultsmentioning

confidence: 99%

Prognostic role of selection criteria for liver transplantation in patients with hepatocellular carcinoma: a network meta-analysis

et al. 2022

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“…According to the UTSC, the 5-year survival rate after a transplant is 71.2%. One of the latest studies, by Diaz et al [15], reviewed the trans-plantations performed at their unit by dividing these transplantations into three groups: patients within the Milan criteria; patients outside the Milan criteria but within the UTSC; and patients outside the UTSC. Out of the total 91 patients, the maximum number of patients were within the Milan criteria ( n = 74) and only 12 patients were outside the Milan criteria but within the UTSC.…”

Section: Extended Criteria For Olt In Hccmentioning

confidence: 99%

Hepatocellular carcinoma – time to take the ticket

Mullath

Krishna²

2019

WJGS

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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.

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“…Patients with early-stage HCC and well-compensated cirrhosis usually represent a low transplant benefit category, since they show great potential for non-transplant curative therapies, such as liver resection or ablation, as alternatives to LT [ 5 ]. Intermediate-stage HCC patients have an optimal post-LT outcome when they fulfill validated extended criteria [ 6 , 7 , 8 , 9 ] or when they have a good response to a downstaging protocol [ 10 , 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

Sustained Complete Response after Biological Downstaging in Patients with Hepatocellular Carcinoma: XXL-Like Prioritization for Liver Transplantation or “Wait and See” Strategy?

Vitale

Scolari

Bertacco

et al. 2021

Cancers

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The XXL trial represents the first prospective validation of “biological downstaging” in liver transplantation (LT) for hepatocellular carcinoma. The aim of this study was to compare the Padua downstaging protocol to the XXL protocol in terms of downstaging failure rates and patient outcome. A total of 191 patients undergoing aggressive surgical downstaging and potentially eligible for LT from 2012 to 2018 at our center were retrospectively selected according to XXL trial criteria. Unlike the XXL trial, patients with a complete response to downstaging did not receive any prioritization for LT. Downstaging failure was defined as stable progressive disease or post-treatment mortality. The statistical method of “matching-adjusted indirect comparison” was used to match the study group to the XXL population. Downstaging failure rate was considerably lower in the study group than in the XXL trial (12% vs. 32%, d value = |0.683|). The survival curves of our LT group (n = 68) overlapped with those of the LT-XXL group (p = 0.846). Survival curves of non-LT candidates with a sustained complete response (n = 64) were similar to those of transplanted patients (p = 0.281). Our study represents a validation of the current Padua and Italian policies of denying rapid prioritization to patients with complete response to downstaging. Such a policy seems to spare organs without worsening patient outcome.

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Up-to-7 Criteria for Hepatocellular Carcinoma Liver Transplantation: A Retrospective Analysis of Experiences

Cited by 6 publications

References 8 publications

Prognostic role of selection criteria for liver transplantation in patients with hepatocellular carcinoma: a network meta-analysis

Prognostic role of selection criteria for liver transplantation in patients with hepatocellular carcinoma: a network meta-analysis

Hepatocellular carcinoma – time to take the ticket

Sustained Complete Response after Biological Downstaging in Patients with Hepatocellular Carcinoma: XXL-Like Prioritization for Liver Transplantation or “Wait and See” Strategy?

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