Qu Z, et al. - Researchers evaluated the Hangzhou criteria in predicting long-term survival after liver transplantation for hepatocellular carcinoma (HCC) in a German cohort. Outcomes suggest that compared to Milan criteria, Hangzhou criteria is superior in predicting long-term survival after liver transplantation for HCC in Germany. The pool of transplantable patients could be enlarged via deployment of the Hangzhou criteria for patient selection.

Methods

• This investigation included 159 patients transplanted for HCC between 1975 and 2010.
• Depending on the fulfillment of Milan and Hangzhou criteria, researchers categorized patients into four groups.
• Comparison of general and tumor baseline characteristics was performed.
• The Kaplan-Meier analysis was used to determine overall and tumor-free survival rates.

Results

• For patients fulfilling Milan criteria (n = 68), 1-, 3-, 5-, and 10-year survival rates were 89.7, 83.7, 75.8, and 62.1%, respectively, vs 89.8, 82.2, 75.2, and 62.6% for patients fulfilling Hangzhou criteria (n = 109) (p=0.833).
• Survival rates were 75.3, 53.2, 48.1, and 41.1% vs 63.3, 31.4, 26.9, and 22.1%, respectively, when comparing patients exceeding Milan or Hangzhou criteria (p=0.019).
• Patients fulfilling Milan or Hangzhou criteria were not significantly different regarding the tumor-free survival rates (p = 0.785), however, the comparison of the groups exceeding the criteria showed markedly worse survival for patients outside Hangzhou criteria (p=0.007).
• Significantly larger proportion of patients were identified fulfilling Hangzhou criteria (68.6%) compared to the proportion fulfilling Milan criteria (42.8%) (p < 0.001).