title: LIVER TRANSPLANTATION FOR CARCINOMA HEPATOCELLULAR IN SÃO PAULO: 414 CASES BY THE MILAN/BRAZIL CRITERIA.
abstract: The criterion of Milan (CM) has been used as standard for indication of liver transplantation (LTx) for hepatocellular carcinoma (HCC) worldwide for nearly 20 years. Several centers have adopted criteria expanded in order to increase the number of patients eligible to liver transplantation, while maintaining good survival rates. In Brazil, since 2006, the criterion of Milan/Brazil (CMB), which disregards nodules <2 cm, is adopted, including patients with a higher number of small nodules.
  
  
  
  To evaluate the outcome of liver transplantation within the CMB.
  
  
  
  The medical records of patients with HCC undergoing liver transplantation in relation to recurrence and survival by comparing CM and CMB, were analyzed.
  
  
  
  414 LTx for HCC, the survival at 1 and 5 years was 84.1 and 72.7%. Of these, 7% reached the CMB through downstaging, with survival at 1 and 5 years of 93.1 and 71.9%. The CMB patient group that exceeded the CM (8.6%) had a survival rate of 58.1% at five years. There was no statistical difference in survival between the groups CM, CMB and downstaging. Vascular invasion (p<0.001), higher nodule size (p=0.001) and number of nodules >2 cm (p=0.028) were associated with relapse. The age (p=0.001), female (p<0.001), real MELD (p<0.001), vascular invasion (p=0.045) and number of nodes >2 cm (p<0.014) were associated with worse survival.
  
  
  
  CMB increased by 8.6% indications of liver transplantation, and showed survival rates similar to CM.
authors.affiliation: Postgraduation Program in Interdisciplinary Surgical Science, Federal University of São Paulo, São Paulo, SP, Brazil.
authors.forename: Gustavo Pilotto D
authors.initials: GP
authors.lastname: Sá
authors.affiliation: Postgraduation Program in Interdisciplinary Surgical Science, Federal University of São Paulo, São Paulo, SP, Brazil.|; Sector of Liver Transplantation, Discipline of Surgical Gastroenterology, Federal University of São Paulo; São Paulo, SP, Brazil.
authors.forename: Fernando P P
authors.initials: FP
authors.lastname: Vicentine
authors.affiliation: Postgraduation Program in Interdisciplinary Surgical Science, Federal University of São Paulo, São Paulo, SP, Brazil.|; Sector of Liver Transplantation, Discipline of Surgical Gastroenterology, Federal University of São Paulo; São Paulo, SP, Brazil.
authors.forename: Alcides A
authors.initials: AA
authors.lastname: Salzedas-Netto
authors.affiliation: ; Sector of Liver Transplantation, Discipline of Surgical Gastroenterology, Federal University of São Paulo; São Paulo, SP, Brazil.
authors.forename: Carla Adriana Loureiro de
authors.initials: CA
authors.lastname: Matos
authors.affiliation: ; Sector of Liver Transplantation, Discipline of Surgical Gastroenterology, Federal University of São Paulo; São Paulo, SP, Brazil.
authors.forename: Luiz R
authors.initials: LR
authors.lastname: Romero
authors.affiliation: ; Sector of Liver Transplantation, Discipline of Surgical Gastroenterology, Federal University of São Paulo; São Paulo, SP, Brazil.
authors.forename: Dario F P
authors.initials: DF
authors.lastname: Tejada
authors.affiliation: Sector of Liver Transplantation, Department of Surgery, Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil.
authors.forename: Paulo Celso Bosco
authors.initials: PC
authors.lastname: Massarollo
authors.affiliation: Postgraduation Program in Interdisciplinary Surgical Science, Federal University of São Paulo, São Paulo, SP, Brazil.|; Sector of Liver Transplantation, Discipline of Surgical Gastroenterology, Federal University of São Paulo; São Paulo, SP, Brazil.
authors.forename: Gaspar J
authors.initials: GJ
authors.lastname: Lopes-Filho
authors.affiliation: Postgraduation Program in Interdisciplinary Surgical Science, Federal University of São Paulo, São Paulo, SP, Brazil.|; Sector of Liver Transplantation, Discipline of Surgical Gastroenterology, Federal University of São Paulo; São Paulo, SP, Brazil.
authors.forename: Adriano M
authors.initials: AM
authors.lastname: Gonzalez
mesh_terms: D001938:Brazil; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery*; D005260:Female; D006801:Humans; D007558:Italy; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015996:Survival Rate