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Malatya and Other Criteria for Liver Transplantation in Hepatocellular Carcinoma

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Abstract

Purpose

Liver transplantation is a curative treatment option for hepatocellular carcinoma. In this review, we aimed to review liver transplantation criteria for hepatocellular carcinoma and patient survivals.

Methods

We reviewed literature in terms of liver transplant criteria for hepatocellular carcinoma. Patient eligibility criteria, post-transplant survivals, tumor recurrence and expansion of Milan criteria rates were analyzed.

Results

The Milan criteria, after being published in 1996, have become for deceased donor liver transplantation in hepatocellular carcinoma worldwide. Later, many transplant centers published their own liver transplant criteria. Most of the criteria consisted of morphological tumor characteristics based on tumor size and number. The newest published one is Malatya criteria. The 5-year overall survival according the all of the criteria is greater than 50%. There were just one paper which compare criteria according to survival and Malatya criteria were the best amongst extended criteria with 5-year OS 79.7% in that study.

Conclusion

It is clear that morphological criteria consisting only of tumor size and number are insufficient in patient selection for liver transplantation and should thus be combined with biological, inflammatory, radiological, pathological and genetic markers that predict the biological behavior of the tumor. Efforts to find the best criteria are still ongoing and 5-year overall survival should be greater than 60%.

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Abbreviations

AFP:

Alpha fetoprotein

BCLC:

Barcelona Clinic Liver Cancer extended criteria

DDLT:

Deceased donor liver transplantation

ETC:

Extended Toronto criteria

GGT:

Gamma glutamyl transferase

HC:

Hagzhou criteria

HCC:

Hepatocellular cancer

LT:

Liver transplantation

LDLT:

Live donor liver transplantation

LRT:

Loco-regional therapy

MC:

Milan criteria

MTD:

Maximal tumor diameter

NLR:

Neutrophil-lymphocyte ratio

OS:

Overall survival

PET/CT:

Positron Emission Tomography / computerized tomography scan

TTS:

Total tumor size

UCSF:

University of California, San Francisco criteria

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Authors and Affiliations

  1. Department of Surgery, Liver Transplantation Institute, Inonu University, 44315, Malatya, Turkey

    Volkan Ince, Cengiz Ara & Sezai Yilmaz

Authors
  1. Volkan Ince
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  2. Cengiz Ara
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Contributions

Volkan Ince and Sezai Yilmaz had the idea for the article,

Volkan Ince and Cengiz Ara performed the literature search and data analysis,

Volkan Ince, Cengiz Ara, and Sezai Yilmaz drafted and/or critically revised the work.

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Correspondence to Volkan Ince.

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Ince, V., Ara, C. & Yilmaz, S. Malatya and Other Criteria for Liver Transplantation in Hepatocellular Carcinoma. J Gastrointest Canc 51, 1118–1121 (2020). https://doi.org/10.1007/s12029-020-00484-y

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