Liver transplantation and multivisceral transplantation in the management of patients with advanced neuroendocrine tumours

Table 1 Results from liver transplantation in selected registry reports, multicentre series and recent single centre series

Ref.	Year	Study type/setting	Total patients	Overall survival (%)							Disease-free survival (%)
					1 yr	2 yr	3 yr	4 yr	5 yr	10 yr	1 yr	2 yr	3 yr	4 yr	5 yr	10 yr
Nobel et al[58]	2015	Registry (UNOS)	120		87		69		63
Le Treut et al[38]	2013	Registry (ELTR)	213 (6 MVT)	Overall	81	73	65	55	52		65	49	40	33	30
				ELTR score 0-1					79						57
				ELTR score 2-3					38						19
Nguyen et al[40]	2011	Registry (UNOS)	184	Overall	79.5		61.4		49.2
				Post-MELD	84.7		65		57.8
Gedaly et al[37]	2011	Registry (UNOS)	150 (13 MVT)		80		64		48		771		501		321
Sher et al[51]	2015	Multicentre series (United States)	85		83		60		52
Mazzaferro et al[9]	2016	Single centre series (Italy)	42						97.2	88.8					86.9	86.9
Bonaccorsi-Riani et al[59]	2010	Single centre series (Belgium)	9		88		77		33		67		33		11
Olausson et al[50]	2007	Single centre series (Sweden)	15 (5 MVT)						90				70		20
Van Vilsteren et al[60]	2006	Single centre series (United States)	19		88						80
Frilling et al[61]	2006	Single centre series (Germany)	15 (1 MVT)		78.3				67.2		69.4				48.3

Calculated from 83 patients. UNOS: United Network for Organ Sharing (United States); ELTR: European Liver Transplant Registry; MELD: Modified end-stage liver disease score; MVT: Multivisceral transplantation.

Table 2 Comparison of published selection criteria for liver transplantation in neuroendocrine liver metastases, and cirrhosis with hepatocellular carcinoma

Criteria and context	Parameters
Milan NET criteria[42] Neuroendocrine liver metastases	Age < 60 G1/G2 tumour grade Primary tumour drained by the portal venous system Metastatic involvement limited to the liver Hepatic tumour burden not > 50% Six months of no tumour progression
Milan criteria[62] HCC and cirrhosis	Single tumour ≤ 5 cm Or, ≤ 3 tumours each ≤ 3 cm in size No macrovascular invasion
UCSF criteria[63] HCC and cirrhosis	Single lesion ≤ 6.5 cm Or, 2-3 lesions ≤ 4.5 cm each, with total tumour diameter ≤ 8 cm No macrovascular invasion
Navarro criteria[64] HCC and cirrhosis	Single lesion ≤ 6 cm Or, 2-3 lesions ≤ 5 cm each No macrovascular invasion
Valencia criteria[65] HCC and cirrhosis	1-3 lesions ≤ 5 cm each, total tumour dimeter ≤ 10 cm No macrovascular invasion
‘Up-to-7’ criteria[66] HCC	Number of tumours + size of tumours (in cm) ≤ 7 No microvascular invasion

HCC: Hepatocellular carcinoma; G: Grade.