Criteria and prognostic models for patients with hepatocellular carcinoma undergoing liver transplantation

Sha, Meng; Wang, Jun; Cao, Jie; Zou, Zhi-Hui; Qu, Xiao-ye; Xi, Zhi-feng; Shen, Chuan; Tong, Ying; Zhang, Jian-jun; Jeong, Seogsong; Xia, Qiang

doi:.0..

Review Article

Criteria and prognostic models for patients with hepatocellular carcinoma undergoing liver transplantation

Meng Sha¹, Jun Wang³, Jie Cao¹, Zhi-Hui Zou⁴, Xiao-ye Qu¹, Zhi-feng Xi¹, Chuan Shen¹, Ying Tong¹, Jian-jun Zhang¹, Seogsong Jeong², Qiang Xia¹

¹Department of Liver Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
²Department of Biomedical Informatics, Korea University College of Medicine, Seoul, Korea
³State Key Laboratory of Systems Medicine for Cancer, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
⁴Department of Hepatic Surgery VI, Eastern Hepatobiliary Surgery Hospital, Naval Military Medical University, Shanghai, China

Correspondence :

Seogsong Jeong ,
Tel: 82-2-3407-4085, Email: seogsongjeong@korea.ac.kr
Qiang Xia ,
Email: xiaqiang@shsmu.edu.cn

Received: April 30, 2024 Revised: August 11, 2024 Accepted: August 12, 2024
*Meng Sha and Jun Wang contributed equally to this work.

ABSTRACT

Hepatocellular carcinoma (HCC) is a leading cause of cancer-associated death globally. Liver transplantation (LT) has emerged as a key treatment for patients with HCC, and the Milan criteria have been adopted as the cornerstone of the selection policy. To allow more patients to benefit from LT, a number of expanded criteria have been proposed, many of which use radiologic morphological characteristics with larger and more tumors as surrogates to predict outcomes. Other groups developed indices incorporating biological variables and dynamic markers of response to locoregional treatment. These expanded selection criteria achieved satisfactory results with limited liver supplies. In addition, a number of prognostic models have been developed using clinicopathological characteristics, imaging radiomics features, genetic data, and advanced techniques such as artificial intelligence. These models could improve prognostic estimation, establish surveillance strategies, and bolster long-term outcomes in patients with HCC. In this study, we reviewed the latest findings and achievements regarding the selection criteria and post-transplant prognostic models for LT in patients with HCC.

KeyWords: hepatocellular carcinoma; liver transplantation; criteria; prognostic model