A 37-year-old member asked:
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is it possible for liver cancer tumors to be too big for a transplant?

3 doctor answers
Dr. Edward Gold
43 years experience Internal Medicine
Yes: According to the current tnm/uicc staging system for hepatocellular carcinoma most consider stages iiib, iiic, and stage iva, as well as stage ivb, disease to be incurable by resection.
Answered on May 2, 2015
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Dr. Debashish Bose
18 years experience General Surgery
Milan criteria: Most transplant programs adhere to some form of the milan criteria that restrict transplants to persons with one tumor<5 cm, up to 3 tumors<3cm, no extrahepatic disease, and no vascular invasion. Size is a marker for vascular invasion. Some programs have adjusted these criteria. Some tumors not amenable to transplant may nevertheless be resected (removed) surgically.
Answered on Jan 2, 2015
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Dr. Richard Mangus
21 years experience Transplant Surgery
Try to shrink tumors: Transplant is the best treatment for certain liver cancers. Though all centers have criteria for acceptable tumor size in liver transplantation, there are mechanisms to improve the chances of approval for transplant. Liver directed therapy can be used to shrink tumors - embolization, radiation, etc. If they shrink, you may be reconsidered for transplant at some centers if within criteria.
Answered on Sep 16, 2013
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1 comment
Dr. Aaron Shiloh
27 years experience Aesthetic Medicine
There are several studies that have shown promise for patients to be downstaged to transplantation with y90 Therasphere.
Sep 14, 2013

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