Clinical Research
Copyright ©2006 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Nov 21, 2006; 12(43): 6992-6997
Published online Nov 21, 2006. doi: 10.3748/wjg.v12.i43.6992
Milan criteria are useful predictors for favorable outcomes in hepatocellular carcinoma patients undergoing liver transplantation after transarterial chemoembolization
Do Young Kim, Moon Seok Choi, Joon Hyoek Lee, Kwang Cheol Koh, Seung Woon Paik, Byung Chul Yoo, Sung Wook Shin, Sung Wook Choo, Young Soo Do, Jong Chul Rhee
Do Young Kim, Moon Seok Choi, Joon Hyoek Lee, Kwang Cheol Koh, Seung Woon Paik, Byung Chul Yoo, Jong Chul Rhee, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
Sung Wook Shin, Sung Wook Choo, Young Soo Do, Depart-ment of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
Author contributions: All authors contributed equally to the work.
Correspondence to: Dr. Moon Seok Choi, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-Gu, 135-710, Seoul, South Korea. mschoi@smc.samsung.co.kr
Telephone: +82-2-34013409 Fax: +82-2-34103849
Received: July 18, 2006
Revised: September 25, 2006
Accepted: October 6, 2006
Published online: November 21, 2006
Abstract

AIM: To evaluate whether the Milan criteria are useful in patients with hepatocellular carcinoma (HCC) who received transarterial chemoembolization (TACE) before liver transplantation (LT).

METHODS: Thirty-six HCC patients who fulfilled the Milan criteria after having received TACE and subsequently underwent LT were included (TACE + LT group) in the study. As controls, 21 patients who also met the Milan criteria and underwent LT without prior treatment were selected (LT group). Post-LT clinical outcomes, such as HCC recurrence, survival rate, and histologic features of explanted livers, were compared between the two groups.

RESULTS: Baseline characteristics were not different between the two groups. Pre-LT maximal tumor diameter in TACE + LT group was similar to that of LT group (2.0 ± 0.6 cm vs 2.3 ± 0.9 cm; P = 0.10). Post-LT histologic findings also revealed similar maximal tumor diameter in the two groups (2.4 ± 1.4 cm vs 2.3 ± 0.9 cm; P = 0.70). Explanted livers showed similar incidence of unfavorable pathologic features. The morality within 60 d after transplantation was not different between the two groups (8.3% vs 9.5%; P = 0.99). Post-LT 5-year survival rate (57% vs 74%; P = 0.70) and cumulative recurrence rate (8.3% vs 4.8%; P = 0.90) were not significantly different between the two groups.

CONCLUSION: The Milan criteria are still a useful selec-tion criteria showing favorable outcomes in HCC patients receiving TACE before LT.

Keywords: Milan criteria; Hepatocellular carcinoma; Transarterial chemoembolization; Liver transplantation