title: Outcome comparisons among the Hangzhou, Chengdu, and UCSF criteria for hepatocellular carcinoma liver transplantation after successful downstaging therapies.
abstract: BACKGROUND
  In Mainland China, many selection criteria for hepatocellular carcinoma (HCC) liver transplantation, such as the Hangzhou, the Chengdu, and the Fudan criteria, have been established. No comparisons have been made among the outcomes using the Hangzhou, Chengdu, and University of California, San Francisco (UCSF) criteria in patients who underwent successful downstaging therapies.
  
  
  METHODS
  After successful downstaging therapies, 72 patients met the UCSF criteria, 86 met the Chengdu criteria, and 102 met the Hangzhou criteria. The data on these HCC patients were retrospectively analyzed, and various outcomes, such as survival and the tumor-free survival rate, were compared among the three groups.
  
  
  RESULTS
  No significant differences were observed among the three groups with regard to the downstaging protocols, baseline characteristics, or liver function. However, the patients who met the Hangzhou criteria had significantly larger tumor targets than those who met the Chengdu or UCSF criteria (P < 0.05). The three groups showed similar 1-, 3-, and 5-year survival rates (90.9, 80.0, and 78.6 %, respectively, for the UCSF criteria; 91.6, 81.9, and 75.6 %, respectively, for the Hangzhou criteria; and 91.1, 83.3, and 79.4 %, respectively, for the Chengdu criteria); 1-, 3-, and 5-year tumor-free survival rates (83.3, 77.5, and 75 %, respectively, for the UCSF criteria; 86.3, 78.8, and 75.6 %, respectively, for the Hangzhou criteria; and 87.3, 79.2, and 76.4 %, respectively, for the Chengdu criteria); and 1-, 3-, and 5-year tumor recurrence rates (9.2, 17.5, and 21.4 %, respectively, for the UCSF criteria; 8.4, 16.4, and 20 % for the Hangzhou criteria; and 8.9, 14.6, and 17.6 % for the Chengdu criteria).
  
  
  CONCLUSIONS
  Because they have contributed to similar outcomes but to larger HCC patient pools, the Hangzhou criteria for HCC transplantation should be comprehensively accepted in China for HCC patients after successful downstaging therapies.
authors: Liver Transplantation Center, West China Hospital of Sichuan University, Chengdu, 610041, China. leijianyong11@163.com
authors: Jianyong
authors: J
authors: Lei
authors: Lunan
authors: L
authors: Yan
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000008:administration & dosage; D006528:Carcinoma, Hepatocellular / Q000556:secondary* / Q000601:surgery / Q000628:therapy*; D017115:Catheter Ablation; D016461:Chemoembolization, Therapeutic; D018572:Disease-Free Survival; D005260:Female; D057086:High-Intensity Focused Ultrasound Ablation; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000473:pathology* / Q000601:surgery / Q000628:therapy*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D009367:Neoplasm Staging; D018579:Patient Selection; D012189:Retrospective Studies; D015996:Survival Rate; D047368:Tumor Burden
chemical_list: D000970:Antineoplastic Agents