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Eur J Surg Oncol. 2005 Nov;31(9):994-9. Epub 2005 Aug 1.

Tumour size is an important predictor for the outcome after liver transplantation for hepatocellular carcinoma.

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  • 1Department of Surgery, Ludwig-Maximilians-University of Munich, Klinikum Grosshadern, Marchioninistr. 15, D-81377 Munich, Germany.



Recently, there is a tendency to expand tumour sizes qualifying for OLT. The present study re-evaluates tumour size and histopathological features as selection criteria for OLT.


Retrospective analysis of 93 adult HCC patients underwent OLT between June 1985 and December 2003. Median follow-up was 28 months (1-222 months). The Milan criteria were routinely applied since 1994.


Five year survival rate of HCC patients was significantly lower than in patients transplanted for benign diseases, 41 and 71%, respectively (p<0.0001). Multivariate analysis revealed that the presence of vascular invasion represents the most significant predictor (p<0.001) affecting the survival rate. Survival was also significantly impaired when the tumour size was >5 cm (p<0.05), whereas the number of nodules had no significant effect on survival. Consequently, the survival rate for HCC fulfilling the Milan criteria histologically improved to 70% since 1994.


Tumour size has been shown to be the most important pre-operatively detectable predictor for patient survival after OLT.

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