What are the survival rates for hepatocellular carcinoma (HCC) following liver transplantation?

Updated: Jan 31, 2021
  • Author: Luca Cicalese, MD, FACS; Chief Editor: John Geibel, MD, MSc, DSc, AGAF  more...
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Answer

The approach to patients with HCC was dramatically altered by the 1996 publication of the results from Mazzaferro et al in Milan, [82] who demonstrated that patients with limited HCC tumor burden could achieve posttransplant patient survival rates equivalent to patients without malignancies. Mazzaferro defined the Milan criteria, which have been used to determine candidacy for OLT.

In the experience of the Milan investigators, patients with established cirrhosis and either a single HCC no larger than 5 cm in diameter or as many as three HCCs no larger than 3 cm had a 4-year overall survival rate of 85% and a tumor-free survival rate of 92%. By comparison, patients with a large tumor burden had a 4-year survival rate of 50%. After this report, OLT was established as the therapy of choice for patients with significant cirrhosis and limited tumor burden. [82, 83, 84, 85]

These results were subsequently duplicated by several other transplant centers (see Table 3 below). [82]

Table 3. Patient Survival Rates Following Liver Transplantation for Hepatocellular Carcinoma (Open Table in a new window)

Author (Year)

N

Survival Rate

1 year

5 years

Mazzefero (1996)

48

84%

74%

Bismuth (1999)

45

82%

74%

Llovet (1999)

79

86%

75%

Jonas (2001)

120

90%

71%


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