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Liver Transplantation as a Curative Approach for Patients With Nonresectable Colorectal Liver Metastases
Fasih Ali Ahmed1, Yong K Kwon, Shannon Zielsdorf
1From the Department of Surgery, Division of Surgical Oncology, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA.
Summary
Liver transplant offers improved survival for select patients with isolated colorectal liver metastasis. Careful patient selection based on disease characteristics and treatment history is crucial for successful outcomes.
Area of Science:
- Hepatobiliary surgery
- Surgical oncology
- Gastroenterology
Background:
- Liver transplant is an emerging treatment for isolated colorectal liver metastasis.
- Published literature on liver transplant outcomes in these patients is analyzed.
Purpose of the Study:
- To evaluate the feasibility and outcomes of liver transplant for isolated colorectal liver metastasis.
- To identify optimal patient selection criteria for this procedure.
Main Methods:
- Analysis of four prospective studies on liver transplant for colorectal liver metastasis.
- Review of clinical outcomes, overall survival, and disease-free survival.
Main Results:
- The SECA-II trial showed high survival rates (100% at 1 year) with narrow inclusion criteria.
- Extended criteria in the same trial led to significantly lower survival (median 18 months).
Conclusions:
- Liver transplant can offer prolonged overall survival compared to other therapies.
- Key selection criteria include less aggressive disease, good performance status, prior chemotherapy, low risk scores, and negative nodal disease.
- Exclusion criteria such as right-sided primary tumors and specific biomarkers (CA19-9 with BRAF mutation) warrant further investigation.
