title: Hepatectomy for hepatocellular carcinoma patients who meet the Milan criteria.
abstract: OBJECTIVE
  Although hepatocellular carcinoma patients who meet the Milan criteria are optimal candidates for liver transplantation, most such patients in Japan have been treated without liver transplantation.
  
  
  METHODS
  In this retrospective analysis, the patient selection criteria were (1) admission between 1992 and 2005, (2) fulfillment of the Milan criteria, (3) classification within the Barcelona Clinic Liver Cancer stages A1-A4, and (4) no previous anticancer treatment.
  
  
  RESULTS
  Of 451 patients who met the selection criteria, 162 underwent hepatectomy. The proportion of patients who underwent hepatectomy was 58% of 106 with stage A1 and 29% of 345 with stages A2-A4. For patients with stages A2-A4, the survival probability after hepatectomy at 3, 5, and 7 years was 89%, 70%, and 61%, respectively. There were no significant differences in survival time between stages A1 and stages A2-A4 after hepatectomy. Among patients with Child-Pugh scores of 5 and 6 in stages A2-A4, 51% and 29% underwent hepatectomy, respectively.
  
  
  CONCLUSIONS
  Hepatectomy may be an appropriate first-line treatment option for patients with stages A2-A4 who meet the Milan criteria, when they have a good hepatic reserve and a long waiting time for liver transplantation.
authors.affiliation: Division of Hepatobiliary and Pancreatic Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan. hirishii@east.ncc.go.jp
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ishii
authors.forename: Junji
authors.initials: J
authors.lastname: Furuse
authors.forename: Taira
authors.initials: T
authors.lastname: Kinoshita
authors.forename: Masaru
authors.initials: M
authors.lastname: Konishi
authors.forename: Toshio
authors.initials: T
authors.lastname: Nakagohri
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Takahashi
authors.forename: Naoto
authors.initials: N
authors.lastname: Gotohda
authors.forename: Kohei
authors.initials: K
authors.lastname: Nakachi
authors.forename: Ei-ichiro
authors.initials: E
authors.lastname: Suzuki
authors.forename: Masahiro
authors.initials: M
authors.lastname: Yoshino
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000601:surgery*; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies