title: Comparison of survival and tumor recurrence rates in patients undergoing liver transplantation for hepatitis B-related hepatocellular carcinoma using Milan, Shanghai Fudan and Hangzhou criteria.
abstract: To assess the performance of the Milan, Shanghai Fudan and Hangzhou criteria based on a preoperative evaluation in patients undergoing liver transplantation (LT) for hepatitis B-related hepatocellular carcinoma (HCC).
  
  
  
  Using a prospectively collected database, the data of consecutive patients with hepatitis B-related HCC undergoing LT at the Department of Liver Surgery of Ren Ji Hospital, School of Medicine, Shanghai Jiaotong University from January 2005 to December 2009 were reviewed. Overall survival and tumor recurrence rates of patients fulfilling the Milan, Shanghai Fudan and Hangzhou criteria were compared using log-rank test.
  
  
  
  Altogether 148 patients were enrolled in the study, among whom 88 fulfilled the Milan criteria and 24 and 39 were beyond Milan but within the Shanghai Fudan or Hangzhou criteria, respectively. After a median follow-up of 44 months, survival rates did not differ among the three groups (P = 0.8780). Recurrence rates were significantly higher for newly eligible patients by the Shanghai Fudan or Hangzhou criteria compared with those within the Milan criteria.
  
  
  
  The Milan criteria should be used as the preferred criteria for the selection of hepatitis B-related HCC for LT. Considering the high tumor recurrence rates and donor scarcity, a moderate expansion of the Milan criteria must be performed cautiously until high-quality clinical trials are conducted.
authors.affiliation: Department of Gastroenterology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, China.
authors.forename: Ting
authors.initials: T
authors.lastname: Gao
authors.forename: Qiang
authors.initials: Q
authors.lastname: Xia
authors.forename: De Kai
authors.initials: DK
authors.lastname: Qiu
authors.forename: Yi Yan
authors.initials: YY
authors.lastname: Feng
authors.forename: Jia Chang
authors.initials: JC
authors.lastname: Chi
authors.forename: Si Yue
authors.initials: SY
authors.lastname: Wang
authors.forename: Zhi Feng
authors.initials: ZF
authors.lastname: Xi
authors.forename: Jian Jun
authors.initials: JJ
authors.lastname: Zhang
authors.forename: Ning
authors.initials: N
authors.lastname: Xu
authors.forename: Shi Yao
authors.initials: SY
authors.lastname: Chen
authors.forename: Yu Lan
authors.initials: YL
authors.lastname: Qiu
authors.forename: Li Wei
authors.initials: LW
authors.lastname: Shen
authors.forename: Ting Ting
authors.initials: TT
authors.lastname: Zhou
authors.forename: Xiao Jun
authors.initials: XJ
authors.lastname: Dong
authors.forename: Qi Gen
authors.initials: QG
authors.lastname: Li
authors.forename: Hai
authors.initials: H
authors.lastname: Li
mesh_terms: D000328:Adult; D006528:Carcinoma, Hepatocellular / Q000601:surgery* / Q000821:virology; D016208:Databases, Factual; D005260:Female; D006509:Hepatitis B / Q000150:complications*; D006801:Humans; D008113:Liver Neoplasms / Q000601:surgery* / Q000821:virology; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D018579:Patient Selection; D011379:Prognosis; D012720:Severity of Illness Index; D016019:Survival Analysis; D016896:Treatment Outcome
keywords: Hangzhou criteria; Milan criteria; Shanghai Fudan criteria; hepatitis B virus; hepatocellular carcinoma; liver transplantation