Predictors of outcome after liver transplantation for hepatocellular carcinoma (HCC) beyond Milan criteria

被引:17
作者
Halazun, K. J. [1 ,2 ]
Sapisochin, G. [2 ,3 ]
von Ahrens, D. [1 ]
Agopian, V. G. [4 ]
Tabrizian, P. [5 ]
机构
[1] Weill Cornell Med, Div Liver Transplantat & Hepatobiliary Surg, Dept Surg, 525 East 68th,F-763, New York, NY 10065 USA
[2] Columbia Univ, NY Presbyterian Hosp, Ctr Liver Dis & Transplantat, Med Ctr, 622 West 168th St,PH14-101, New York, NY 10032 USA
[3] Univ Toronto, Toronto Gen Hosp, Div Gen Surg, Multiorgan Transplant, 585 Univ Ave, Toronto, ON M5G 2N2, Canada
[4] Univ Calif Los Angeles, David Geffen Sch Med, Dept Surg, Div Liver & Pancreas Transplantat, 200 UCLA Med Plaza, Los Angeles, CA 90095 USA
[5] Mt Sinai Med Ctr, Dept Transplantat, Recanati Miller Transplantat Inst, 5 East 98th St, New York, NY 10029 USA
关键词
Hepatocellular carcinoma; Liver transplant; Morphometric scores; Locoregional treatment; Downstaging; ALPHA-FETOPROTEIN IMPROVES; GAMMA-CARBOXY PROTHROMBIN; TOTAL TUMOR VOLUME; LIVING DONOR; LYMPHOCYTE RATIO; TRANSARTERIAL CHEMOEMBOLIZATION; EXPANDED CRITERIA; WAITING-LIST; RECURRENCE; CANCER;
D O I
10.1016/j.ijsu.2020.07.029
中图分类号
R61 [外科手术学];
学科分类号
摘要
The Milan criteria have been the cornerstone of selection policies for patients with hepatocellular carcinoma (HCC) awaiting liver transplantation (LT) globally for over two decades. Many groups have proposed the transplantation of patients with larger and more numerous tumors achieving comparable results. Many of these use radiologic morphometric criteria as surrogates for explant pathology to predict outcomes. Several other indices have been developed both within and beyond Milan incorporating biological indices as well as dynamic markers of response to pre-transplant locoregional treatments and waiting time. These have allowed for successful expansion of transplant selection criteria without compromising outcomes with limited organ supplies. In this review we will discuss the predictors of outcome in patients beyond Milan criteria.
引用
收藏
页码:61 / 69
页数:9
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