Abstract
Hepatocellular carcinoma (HCC) is a leading cause of cancer deaths worldwide and the incidence and mortality rate are nearly identical in the United States. The Milan Criteria established thresholds of tumor size and number as predictors of optimum overall survival with liver transplant and changed the definitive treatment for HCC. However, after nearly two decades of experience two problems have emerged: post-transplant recurrence continues and an increasing number of patients exceed these size criteria. While tumor burden is an important prognostic factor, it remains limited in its ability to fully define underlying tumor biology and predict recurrence after transplant. Recognizing that tumor size and number are merely surrogate markers of tumor behavior, multiple centers have sought to expand these criteria and consider other oncologic and radiologic factors. Response to locoregional therapies may help to better determine tumor behavior and predict which patients might recur after transplant. Emerging analysis of tumor biology and genetics may also help to predict recurrence more accurately than size alone. Future selection of transplant candidates may be via molecular profiling or chronological imaging changes to identify those patients who would benefit most from the finite number of available grafts, while limiting recurrence after transplant.
Keywords: Hepatocellular carcinoma, transplant, prognosis.
Current Cancer Therapy Reviews
Title:Hepatocellular Carcinoma Outside of the Milan Criteria
Volume: 10 Issue: 3
Author(s): C. Anne Doughtie, Michael E. Egger, Kean O. Feyzeau, Christopher M. Jones, Michael R. Marvin, Kelly M. McMasters and Eric G. Davis
Affiliation:
Keywords: Hepatocellular carcinoma, transplant, prognosis.
Abstract: Hepatocellular carcinoma (HCC) is a leading cause of cancer deaths worldwide and the incidence and mortality rate are nearly identical in the United States. The Milan Criteria established thresholds of tumor size and number as predictors of optimum overall survival with liver transplant and changed the definitive treatment for HCC. However, after nearly two decades of experience two problems have emerged: post-transplant recurrence continues and an increasing number of patients exceed these size criteria. While tumor burden is an important prognostic factor, it remains limited in its ability to fully define underlying tumor biology and predict recurrence after transplant. Recognizing that tumor size and number are merely surrogate markers of tumor behavior, multiple centers have sought to expand these criteria and consider other oncologic and radiologic factors. Response to locoregional therapies may help to better determine tumor behavior and predict which patients might recur after transplant. Emerging analysis of tumor biology and genetics may also help to predict recurrence more accurately than size alone. Future selection of transplant candidates may be via molecular profiling or chronological imaging changes to identify those patients who would benefit most from the finite number of available grafts, while limiting recurrence after transplant.
Export Options
About this article
Cite this article as:
Doughtie C. Anne, E. Egger Michael, O. Feyzeau Kean, M. Jones Christopher, R. Marvin Michael, M. McMasters Kelly and G. Davis Eric, Hepatocellular Carcinoma Outside of the Milan Criteria, Current Cancer Therapy Reviews 2014; 10 (3) . https://dx.doi.org/10.2174/157339471003150212112046
DOI https://dx.doi.org/10.2174/157339471003150212112046 |
Print ISSN 1573-3947 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-6301 |
Call for Papers in Thematic Issues
Current progress in Protein Degradation and Cancer Therapy
argeted Protein Degradation is gaining momentum in cancer therapy, it facilitate targeting undruggable proteins, it overcome cancer resistance and avoid undesirable side effects. Thus small molecules degraders have emerged as novel therapeutic strategy. Targeted protein degradation (TPD), the process of eliminating a protein of interest hold a great promise for ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
Related Articles
-
Characterization of Pharmaceutical IgG and Biosimilars Using Miniaturized Platforms and LC-MS/MS
Current Pharmaceutical Biotechnology Bladder Cancer and Stem Cells
Current Signal Transduction Therapy Ultrasound Contrast Imaging in Cancer –Technical Aspects and Prospects
Current Molecular Imaging (Discontinued) Targeting the Mitochondrial Electron Transport Chain Complexes for the Induction of Apoptosis and Cancer Treatment
Current Pharmaceutical Biotechnology The Safety and Efficacy of Parathyroid Hormone (PTH) as a Biological Response Modifier for the Enhancement of Bone Regeneration
Current Drug Safety Radiolabeled Nanoparticles for Cancer Diagnosis and Therapy
Anti-Cancer Agents in Medicinal Chemistry Replicative Oncolytic Herpes Simplex Viruses in Combination Cancer Therapies
Current Gene Therapy Targeting Transcription Factors for Cancer Therapy
Current Pharmaceutical Design PI3K/Akt/mTOR Pathway Inhibitors in Cancer: A Perspective on Clinical Progress
Current Medicinal Chemistry Pharmacological Modulation of p53 Function in Cancer Therapy
Current Signal Transduction Therapy Evaluation of Vitamin C as a Personalized Adjuvant Medicine: Pharmacogenomic Studies
Current Pharmacogenomics and Personalized Medicine Epigenetic Regulation of Epithelial-Mesenchymal Transition by Hypoxia in Cancer: Targets and Therapy
Current Pharmaceutical Design Chemo-Radiation Association in Head and Neck Squamous Cell Carcinoma: Evidences and Criticisms
Current Drug Therapy The Chlorophyll Catabolite Pheophorbide a as a Photosensitizer for the Photodynamic Therapy
Current Medicinal Chemistry Computer Optimization of Stealth Biodegradable Polymeric Dual-loaded Nanoparticles for Cancer Therapy Using Central Composite Face-centered Design
Pharmaceutical Nanotechnology Risk of Cervical Cancer After HPV Vaccination
Current Pharmaceutical Design Cytoprotection and Immunomodulation in Cancer Therapy
Current Medicinal Chemistry - Anti-Cancer Agents The Competence of 7,8-Diacetoxy-4-Methylcoumarin and Other Polyphenolic Acetates in Mitigating the Oxidative Stress and their Role in Angiogenesis
Current Topics in Medicinal Chemistry Cationic Lipophilic Radiotracers for Functional Imaging of Multidrug Resistance
Current Radiopharmaceuticals Withdrawal Notice: Emerging Biomarkers and Contributing Factors of Prostate Cancer
Current Cancer Therapy Reviews