{"entity":{"id":"paper-mazzaferro-milan-criteria-nejm-1996","kind":"paper","name":"Liver transplantation for small hepatocellular carcinomas in patients with cirrhosis (the Milan criteria)","aka":[],"tldr":"This study showed that liver transplantation cures most patients with cirrhosis whose liver cancer is limited to one tumour up to 5 cm or up to three tumours each up to 3 cm, the Milan criteria that have governed transplant selection ever since.","summary":"Prospective cohort of 48 patients with cirrhosis and unresectable hepatocellular carcinoma meeting size criteria (single tumour 5 cm or less, or up to three tumours each 3 cm or less) who underwent liver transplantation.\n\nFour-year overall survival was 75 percent and recurrence-free survival 83 percent, with 85 percent overall survival among the 35 patients whose explants confirmed the criteria, compared with poor historical results in unselected patients.","asOf":"2026-09-17","links":[{"label":"N Engl J Med 1996","url":"https://doi.org/10.1056/NEJM199603143341104"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/8594428/"}],"tags":[],"related":[],"cancers":["hcc-early"],"sections":[],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":["nejm"],"dependsOn":[],"notes":[],"journal":"New England Journal of Medicine","year":1996,"doi":"10.1056/NEJM199603143341104","pmid":"8594428","authors":"Mazzaferro V, Regalia E, Doci R, et al.","paperType":"observational","findings":["Four-year overall survival 75 percent; recurrence-free survival 83 percent.","85 percent four-year survival when explant pathology confirmed the criteria."],"whatItMeans":"The Milan criteria remain the global standard for transplant eligibility in hepatocellular carcinoma, with downstaging protocols extending access to patients just outside them.","caveats":["Small single-centre series; expanded criteria (UCSF, up-to-seven) have since been proposed."],"changedPractice":true,"participants":48},"route":"/key-papers/paper-mazzaferro-milan-criteria-nejm-1996/","neighbours":{"cancer":[{"id":"hcc-early","kind":"cancer","name":"Early hepatocellular carcinoma (BCLC 0 and A)","route":"/cancers/hcc-early/"}],"journal":[{"id":"nejm","kind":"journal","name":"New England Journal of Medicine","route":"/journals/nejm/"}]}}