Liver transplantation may benefit certain patients with colorectal cancer liver metastases

Sumary of Liver transplantation may benefit certain patients with colorectal cancer liver metastases:

  • Liver transplantation may extend OS compared with portal vein embolization and liver resection for selected patients with advanced colorectal cancer liver metastases and a left-sided primary tumor, according to a study in JAMA Surgery..
  • “Liver transplantation is probably the best medical treatment option for highly selected [patients with colorectal cancer] with liver-only metastases and high tumor load,”.
  • Svein Dueland, MD, PhD, of the clinical cancer research unit in the department of oncology at Oslo University Hospital in Norway, told Healio..
  • The reason for this observation is likely that the liver contains undetectable small liver metastases in addition to metastatic sites determined by MRI/CT scans at time of liver resection..
  • Liver transplantation results in a new liver without occult metastases, eliminating missed tumor cells left in place during a liver resection procedure.”.
  • Dueland and colleagues compared OS among patients with colorectal cancer and high liver metastasis tumor load who underwent liver transplant vs..
  • The analysis included 50 patients with colorectal cancer and liver metastases previously enrolled in liver transplant studies between November 2006 and August 2019 at Oslo University Hospital..
  • Of them, 29 had high tumor load, defined as nine or more metastatic tumors or a diameter of at least 5.5 cm for the largest liver lesion..
  • Researchers compared the liver transplant recipients with a retrospective group of 53 matched patients (median age, 61.8 years;.
  • men, n = 36) from the hospital portal vein embolization (PVE) database who underwent PVE and liver resection between March 2006 and November 2015..
  • Patients with low tumor load had 5-year OS rates of 72.4% with liver transplant and 69.3% with liver resection after PVE..
  • Among patients with high tumor load, researchers observed 5-year OS rates of 33.4% with liver transplant and 6.7% with PVE..
  • Among patients with high tumor load and a left-sided primary tumor, 5-year OS rates were 45.3% for those receiving a liver transplant (vs..
  • “We had previously published that [patients with colorectal cancer] with high tumor load had good overall survival compared with previous published data from patients with less tumor load receiving liver resection, so this confirmed our hypothesis suggesting liver transplantation is probably the best treatment option for these patients if donor grafts are available,”.
  • “Liver transplantation for colorectal cancer liver metastases has for many years been considered a contraindication for liver transplantation at most transplant centers due to the high relapse rate after liver transplantation,”.
  • “We have, in several publications, shown [patients with colorectal cancer] receiving a liver transplant and having a relapse have long overall survival from time of relapse..
  • Yuman Fong, MD, chair and professor in the department of surgery and director in the Center for International Medicine and the Center for Surgical Innovation at City of Hope Medical Center, also acknowledged cadaveric livers for transplant remain a finite resource, noting that more than 1,000 patients die yearly on the waiting list for a transplant…

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