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
Department of Liver Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
State Key Laboratory of Systems Medicine for Cancer, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Clin Mol Hepatol. 2025 Feb;31(Suppl):S285-S300. doi: 10.3350/cmh.2024.0323. Epub 2024 Aug 19.
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.
肝细胞癌（HCC）是全球癌症相关死亡的主要原因。肝移植（LT）已成为HCC患者的关键治疗方法，米兰标准已被用作选择策略的基石。为了让更多患者从肝移植中受益，人们提出了一些扩大标准，其中许多标准使用具有更大更多肿瘤的放射学形态特征作为替代指标来预测预后。其他研究团队开发了纳入生物学变量和局部区域治疗反应动态标志物的指数。这些扩大的选择标准在肝脏供体有限的情况下取得了令人满意的结果。此外，还利用临床病理特征、影像组学特征、基因数据以及人工智能等先进技术开发了一些预后模型。这些模型可以改善预后评估，制定监测策略，并改善HCC患者的长期预后。在本研究中，我们回顾了关于HCC患者肝移植选择标准和移植后预后模型的最新发现和成果。
