Hepatology · Transplant

Metroticket up-to-seven calculator

Enter the published formula inputs below to calculate and interpret this score.

Clinical inputs

Largest tumor

Allowed range: 0.04–11.81 in

Explant diameter of the largest hepatocellular carcinoma in centimeters.

Tumor count

nodules

Allowed range: 1–30 nodules

Number of hepatocellular carcinoma nodules on the explant. The sum is this count plus the largest diameter in centimeters.

Microvascular invasion

The 71.2% 5-year overall survival belongs only to patients inside up-to-seven who had no microvascular invasion.

Result

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Primary source

Mazzaferro V et al. Predicting survival after liver transplantation in patients with hepatocellular carcinoma beyond the Milan criteria: a retrospective exploratory analysis. Lancet Oncol. 2009;10:35-43. DOI: 10.1016/S1470-2045(08)70284-5. PMID: 19058754. The up-to-seven numeric criterion is the largest tumor size in cm plus the number of tumors, and the sum is at most 7. Among 283 patients without microvascular invasion who were within up-to-seven, 5-year overall survival was 71.2% (95% CI 64.3-77.0). That percent is not assigned when invasion is present or when the sum is above 7. The class and that percent follow the unrounded sum. A displayed tenth of 7.0 does not place a sum above 7 inside up-to-seven. Meeting the Milan criteria at explant had 5-year overall survival 73.3% (68.2-77.7), and exceeding Milan had 53.6% (50.1-57.0). Those are group rates. Milan from size and count is one nodule at most 5 cm, or two or three nodules each at most 3 cm. Size and number hazard ratios in the abstract are not used as a survival equation because a baseline survival was not printed. (2009)

Scope: Explant pathology after liver transplantation for hepatocellular carcinoma. This is the 2009 up-to-seven sum, not a later alpha-fetoprotein model.

Last reviewed 2026-10-17

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Professional use only

For qualified clinicians. Independently verify inputs, calculations, source guidance, and applicability before any clinical action. This calculator does not replace clinical judgment.

Source: Mazzaferro V et al. Predicting survival after liver transplantation in patients with hepatocellular carcinoma beyond the Milan criteria: a retrospective exploratory analysis. Lancet Oncol. 2009;10:35-43. DOI: 10.1016/S1470-2045(08)70284-5. PMID: 19058754. The up-to-seven numeric criterion is the largest tumor size in cm plus the number of tumors, and the sum is at most 7. Among 283 patients without microvascular invasion who were within up-to-seven, 5-year overall survival was 71.2% (95% CI 64.3-77.0). That percent is not assigned when invasion is present or when the sum is above 7. The class and that percent follow the unrounded sum. A displayed tenth of 7.0 does not place a sum above 7 inside up-to-seven. Meeting the Milan criteria at explant had 5-year overall survival 73.3% (68.2-77.7), and exceeding Milan had 53.6% (50.1-57.0). Those are group rates. Milan from size and count is one nodule at most 5 cm, or two or three nodules each at most 3 cm. Size and number hazard ratios in the abstract are not used as a survival equation because a baseline survival was not printed. (2009)

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Clinical inputs

Largest tumor (cm)Accepted range: 0.1 to 30
Tumor count (nodules)Accepted range: 1 to 30
Microvascular invasion

Primary source

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