Yao et al increased the limits given by the Milan criteria for when to select a patient with hepatocellular carcinoma arising from cirrhosis for liver transplant. The authors are from the University of California at San Francisco.
Patient selection: cirrhosis with unresectable, early stage hepatocellular carcinoma (and presumably an absence of metastatic disease)
Parameters:
(1) number of tumors
(2) diameter of tumors
(3) sum of tumor diameters
sum of tumor diameters =
= SUM(diameters for all of the tumors)
Number of Tumors
Diameter of Tumor
Sum of Tumor Diameters
Decision
1
<= 6.5 cm
NA
transplant
1
> 6.5 cm
NA
do not transplant
multiple
largest tumor <= 4.5 cm
<= 8 cm
transplant
multiple
largest tumor > 4.5 cm
NA
do not transplant
multiple
largest tumor <= 4.5 cm
> 8 cm
do not transplant
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