ArticleHepatobiliary surgery and nutrition2022
Liver resection versus liver transplantation for hepatocellular carcinoma within Milan criteria: a meta-analysis of 18,421 patients.
Article in Hepatobiliary surgery and nutrition, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 50 papers, 7 of them syntheses that pooled it.
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Who cites it
50 citing papers in PubMed, 7 syntheses or guidelines pooled it, 60 citations in OpenAlex.
- Characteristics and Outcomes of Elderly Hepatocellular Carcinoma Patients following Surgical Resection: Systematic Review and Meta-Analysis.Digestive diseases (Basel, Switzerland) · 2025Pooled it
- Asian Pacific Association for the Study of the Liver clinical practice guidelines on liver transplantation.Hepatology international · 2024Guideline
- Liver transplantation vs liver resection in HCC: promoting extensive collaborative research through a survival meta-analysis of meta-analyses.Frontiers in oncology · 2024Pooled it
- Meta-analysis: Chemoprevention of hepatocellular carcinoma with statins, aspirin and metformin.Alimentary pharmacology & therapeutics · 2023Pooled it
- Global prevalence of depression and anxiety in patients with hepatocellular carcinoma: Systematic review and meta-analysis.Clinical and molecular hepatology · 2022Pooled it
- Global and regional long-term survival following resection for HCC in the recent decade: A meta-analysis of 110 studies.Hepatology communications · 2022Pooled it
- Clinical characteristics, surveillance, treatment allocation, and outcomes of non-alcoholic fatty liver disease-related hepatocellular carcinoma: a systematic review and meta-analysis.The Lancet. Oncology · 2022Pooled it
- Comparison of Long-Term Outcomes of Living-Donor Liver Transplantation in Hepatocellular Carcinoma Based on the Milan Criteria After Downstaging According to Degradable Starch Microspheres with Transcatheter Arterial Chemoembolization.Life (Basel, Switzerland) · 2026Article
- Refining the role of liver transplantation as a curative treatment for hepatocellular carcinoma.International journal of clinical oncology · 2026Review
- Comparison of Milan versus up-to-seven criteria for liver resection in hepatocellular carcinoma: a multi-center study on risk factors and long-term outcomes.Surgical endoscopy · 2026Article
- Shrinking Giants: On the Feasibility of Downsizing Hepatocellular Carcinoma with Immunotherapy Prior to Liver Transplantation.Journal of clinical medicine · 2026Review
- Improving surgical treatments for hepatocellular carcinoma.Nature reviews. Gastroenterology & hepatology · 2026Review
- Non-Transplantable Recurrence After Initial Liver Resection of Hepatocellular Carcinoma: A Narrative Review.Cancers · 2026Review
- Liver resection is associated with better survival than TACE for hepatocellular carcinoma modestly beyond Milan criteria: a multicenter propensity-matched analysis.Frontiers in oncology · 2026Article
- Nanotechnology-Enabled Diagnosis and Treatment of Hepatocellular Carcinoma: Theranostics, Combination Regimens, and Translation.International journal of nanomedicine · 2026Review
- Review
- Minimally Invasive Hepatic Resection Option for Access to the Waiting List of a Single Regional Transplant Center in Southern Italy: Entry and Dropout Flows' Analysis.Journal of clinical medicine · 2025Article
- Disparities in liver transplantation for metabolic dysfunction-associated steatohepatitis-associated hepatocellular carcinoma.World journal of transplantation · 2025Article
- Machine Learning-Based Selection of Resection vs Transplant and Survival in Hepatocellular Carcinoma.JAMA network open · 2025Article
- Tumor-informed circulating tumor DNA assay for surveillance post-liver transplantation in patients with hepatocellular and cholangiocarcinoma.Journal of gastrointestinal oncology · 2025Article
Corrections and comments
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- Commented on byResection2023
Authors and funding
15 authors at 5 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Outcomes after liver resection (LR) and liver transplantation (LT) for hepatocellular carcinoma (HCC) are heterogenous and may vary by region, over time periods and disease burden. We aimed to compare overall survival (OS) and disease-free survival (DFS) between LT versus LR for HCC within the Milan criteria. Methods: Two authors independently searched Medline and Embase databases for studies comparing survival after LT and LR for patients with HCC meeting the Milan criteria. Meta-analyses and metaregression were conducted using random-effects models. Results: We screened 2,278 studies and included 35 studies with 18,421 patients. LR was associated with poorer OS [hazard ratio (HR) =1.44; 95% confidence interval (CI): 1.14-1.81; P<0.01] and DFS (HR =2.71; 95% CI: 2.23-3.28; P<0.01) compared to LT, with similar findings among intention-to-treat (ITT) studies. In uninodular disease, OS in LR was comparable to LT (P=0.13) but DFS remained poorer (HR =2.95; 95% CI: 2.30-3.79; P<0.01). By region, LR had poorer OS versus LT in North America and Europe (P≤0.01), but not Asia (P=0.25). LR had inferior survival versus LT in studies completed before 2010 (P=0.01), but not after 2010 (P=0.12). Cohorts that underwent enhanced surveillance had comparable OS after LT and LR (P=0.33), but cohorts undergoing usual surveillance had worse OS after LR (HR =1.95; 95% CI: 1.24-3.07; P<0.01). Conclusions: Mortality after LR for HCC is nearly 50% higher compared to LT. Survival between LR and LT were similar in uninodular disease. The risk of recurrence after LR is threefold that of LT.
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