Milan criteria for liver transplantation in hepatocellular carcinoma (HCC) specify which tumour parameters?
- A Single tumour ≤6 cm OR up to 3 tumours all ≤3 cm, no vascular invasion, no extrahepatic disease
- B Single tumour ≤4 cm OR up to 4 tumours all ≤2 cm, no vascular invasion
- C Single tumour ≤5 cm OR up to 3 tumours all ≤3 cm, no macrovascular invasion, no extrahepatic spread ✓
- D Total tumour diameter ≤7 cm with any number of nodules
Correct answer: C. Single tumour ≤5 cm OR up to 3 tumours all ≤3 cm, no macrovascular invasion, no extrahepatic spread
Explanation
The Milan criteria (Mazzaferro, 1996) define patients with HCC who achieve excellent post-transplant outcomes: single HCC nodule ≤5 cm in diameter, OR up to 3 nodules each ≤3 cm, with no macrovascular invasion (portal or hepatic vein) and no extrahepatic metastases. 5-year survival exceeds 70% and recurrence-free survival ~83% within Milan criteria. Expanded criteria (UCSF criteria: single ≤6.5 cm, or ≤3 nodules with max 4.5 cm and total diameter ≤8 cm) show comparable outcomes in selected series but have not been universally adopted.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
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