Summary
Abbreviations:
HCC (hepatocellular carcinoma), LT (liver transplantation), UNOS (United Network for Organ Sharing), MC (Milan criteria), EASL (European Association for the Study of the Liver), AASLD (American Association for the Study of Liver Diseases), EC (expanded criteria), UCSF (University of California, San Francisco), WL (waiting list), ITT (intention-to-treat), DS (down-staging), AFP (alpha-fetoprotein), TACE (trans-arterial chemoembolization), RECIST (Response Evaluation Criteria in Solid Tumors), DCP (des-gamma-carboxy-prothrombin)Keywords
Background
Data search methodology

Selection criteria for liver transplantation in HCC-patients
Transplanting HCC-patients with tumors beyond the Milan criteria
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Method of tumor assessment
The dilution effect
Upper tumor size limits
Intention-to-treat principle
Study design
Statistical power
- •5-year survival of 64.9% in group within the MC;
- •5-year survival of 50% in group beyond the MC but within the EC proposal;
- •Bi-directional analysis;
- •Type I error rate alpha level of 5%;
- •Type II error rate beta level of 20%.
Evidence based medicine
Centre for evidence-based medicine (Oxford, UK). <http://www.cebm.net> [accessed February 2011].
Weels GA, Shea B, O’Connel D, Peterson J, Welch V, Losos M, et al. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomized studies in meta-analyses. <http://ohri.ca/programs/clinical_epidemiology/oxford.asp> [accessed February 2011].
- •Radiological assessment properly performed;
- •Prospective design;
- •Comparison between patients within the MC and beyond the MC but within the new proposal;
- •Overall survival as the primary endpoint [[4]];
- •An estimated number of patients of at least 139 patients in each arm.
Transplanting HCC-patients with tumors beyond the conventional criteria using preoperative techniques to fulfill more selective criteria on the basis of tumor number and size
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Listing criteria
Down-staging technique
Down-staging efficacy assessment
Beyond tumor number and size
- Sotiropoulos G.C.
- Malagó M.
- Bockhorn M.
- Schmitz K.J.
- Radtke A.
- Molmenti E.P.
- et al.
Treatment responsiveness
Degree of differentiation
Gene-expression profile
Microvascular invasion
Alpha-fetoprotein levels
- Sotiropoulos G.C.
- Malagó M.
- Bockhorn M.
- Schmitz K.J.
- Radtke A.
- Molmenti E.P.
- et al.
Conclusions
Conflict of interest
Acknowledgment
References
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