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HCC Milan Criteria — SCE Medical Oncology MCQ

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HardGI CancersHCC Milan CriteriaSCE Medical Oncology

A patient with cirrhosis has three hepatocellular carcinomas measuring 2.9, 2.7 and 2.2 cm, no macrovascular invasion and no extrahepatic disease. Liver function precludes resection. How should transplant eligibility be described?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: C — The tumour burden is within Milan criteria; refer for liver-transplant assessment

Explanation lettering: E = shown as A · A = shown as B · B = shown as D · D = shown as E

C is correct. Milan permits a single lesion up to 5 cm or up to three lesions each up to 3 cm, without macrovascular invasion or extrahepatic spread. This patient therefore warrants full transplant assessment; the tumour rule is necessary but not sufficient, because liver disease, performance status, comorbidity, abstinence requirements and transplant-centre criteria also matter. Multifocality within the three-lesion boundary is allowed, the threshold is 3 rather than 2 cm for each lesion, and summing diameters is not a substitute for count, individual size and spread criteria.

Reference: NICE LiMAx evidence summary citing UK transplant selection: https://www.nice.org.uk/advice/mib168/chapter/The-technology