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      Milan criteria are useful predictors for favorable outcomes in hepatocellular carcinoma patients undergoing liver transplantation after transarterial chemoembolization.

      World journal of gastroenterology : WJG
      Adult, Aged, Antineoplastic Agents, administration & dosage, Carcinoma, Hepatocellular, mortality, pathology, therapy, Chemoembolization, Therapeutic, methods, Female, Humans, Injections, Intra-Arterial, Liver, radiography, surgery, Liver Neoplasms, Liver Transplantation, Male, Middle Aged, Neoplasm Staging, Patient Selection, Predictive Value of Tests, Prognosis, Survival Rate, Treatment Outcome

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          Abstract

          To evaluate whether the Milan criteria are useful in patients with hepatocellular carcinoma (HCC) who received transarterial chemoembolization (TACE) before liver transplantation (LT). 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. 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. The Milan criteria are still a useful selection criteria showing favorable outcomes in HCC patients receiving TACE before LT.

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