Francis Yao, MD, gastroenterologist and medical director of the Liver Transplant Program at the University of California San Francisco Medical Center, discusses liver transplants beyond Milan criteria for patients with liver cancer.

Over the past 20 years, physicians' knowledge of liver transplants for patients with liver cancer has increased, explains Yao. In 1996, the Milan criteria was published, suggesting that transplanting in early stages of liver cancer is the best way to achieve positive results. The Milan criteria is one single lesion up to 5 centimeters, or 2 to 3 lesions up to 3 centimeters.

The Milan criteria has been questioned over the past couple of years, according to Yao. There have been some cases where patients have been outside of the Milan criteria and responded positively to the transplant treatment.

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Dr. Yao on Transplants Beyond Milan Criteria for Liver Cancer

Francis Yao, MD, professor of Clinical Medicine and Surgery, medical director of the Liver Transplant Program at UCSF Medical Center, discusses the Milan criteria in liver cancer.

In the past, oncologists tended to transplant bulky tumors and would often see their patients' disease recur, says Yao. The Milan criteria, which were published in 1996, state that a patient with hepatocellular carcinoma (HCC) is selected for transplantation when he or she has a single lesion up to 5 centimeters, or 2 to 3 lesions up to 3 centimeters.

After the Milan criteria became a benchmark for the treatment of patients with HCC, some oncologists began to question whether the size or number of lesions could be expanded. Research suggested that patients with tumor sizes just beyond the Milan criteria may see very positive outcomes, according to Yao. UCSF proposed an updated set of criteria, which expanded the upper limit of the tumor size by 1.5 centimeters, or up to 3 nodules with the largest lesion up to 4.5 centimeters.

View more from the 2016 International Liver Cancer Association Annual Conference

Francis Yao, MD

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