肝细胞癌
米兰标准
医学
肝移植
内科学
移植
癌
胃肠病学
总体生存率
化疗
肿瘤科
外科
作者
Brian Kim,Jeffrey Kahn,Norah A. Terrault
摘要
Abstract Liver transplantation can provide curative therapy in selected patients with hepatocellular carcinoma. Well‐established criteria include tumours that are within the Milan criteria and without evidence of vascular or extrahepatic involvement. Modest expansion of the original Milan criteria has been shown to achieve similar recurrence‐free survival rates. Overall, HCC recurrence occurs in about 10%‐15% of LT recipients, most within the first 2 years. Predictors of post‐transplant recurrence include high alpha‐foetoprotein, macrovascular invasion, as well as tumour size and number. Once HCC recurs after transplantation, prognosis is poor, though better if detected early. There is no established role for systemic prophylactic post‐transplant chemotherapy.
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