Dr. Yao on the Milan Criteria in 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.

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