American Board of Internal Medicine (ABIM) Certification Practice Exam

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What defines the Milan criteria for treating hepatocellular carcinoma?

One tumor ≤3 cm
One tumor ≤5 cm or up to three tumors ≤3 cm
Three tumors ≤5 cm
Two tumors ≤2 cm

The correct answer is: One tumor ≤5 cm or up to three tumors ≤3 cm

The Milan criteria are a set of parameters used to determine the eligibility of patients with hepatocellular carcinoma for liver transplantation. Specifically, the criteria are defined as having either a single tumor measuring 5 cm or smaller, or up to three tumors all measuring 3 cm or smaller. The rationale behind these criteria is that they help identify patients with more localized disease who are more likely to benefit from transplantation and have better overall outcomes. The thresholds within the Milan criteria take into account both the size and the number of tumors, aiming to balance the risks of tumor progression while preserving the possibility of transplantation. Thus, the correct answer correctly reflects this definition, allowing for either the presence of one larger tumor or multiple smaller tumors, highlighting the importance of assessing both dimensions in treatment decisions.