Is Liver Transplantation an Option in Colorectal Cancer Patients with Nonresectable Liver Metastases and Progression on All Lines of Standard Chemotherapy?

Dueland, Svein; Hagness, Morten; Line, Pål–Dag; Guren, Tormod Kyrre; Foss, Aksel

doi:10.1245/s10434-014-4137-0

Cited by 41 publications

(49 citation statements)

References 21 publications

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“…The 5‐year OS was 60%, with a 1‐year disease‐free survival of 35%. Importantly, 90% of patients recurred by the completion of the study . These data are consistent with the aggregate recurrence data calculated in the current study.…”

Section: Discussionsupporting

confidence: 90%

“…Induction immunosuppression was achieved using basiliximab. This same protocol was followed by Line et al and Hrehoret et al, whereas Kocman et al used everolimus instead of sirolimus as an mTOR inhibitor …”

Section: Resultsmentioning

confidence: 99%

“…No patient died during or immediately after LT. One LT patient died 24 days after LT due to complications from hemorrhage, biliary leakage, and renal failure . Another patient developed portal vein stenosis in the graft and ascites that was treated successfully by endovascular grafting . The Oslo University (SECA) group reported four vascular complications, three cases of bile leakage/stenosis that were managed endoscopically, six cases of postoperative hematomas requiring five reoperations, two cases of wound dehiscence and two cases of intestinal obstruction .…”

Section: Resultsmentioning

confidence: 99%

“…These data are consistent with the aggregate recurrence data calculated in the current study. Interestingly, the majority of reported recurrences were single‐site, usually in the lung . In addition, pulmonary recurrences appeared early, were slow growing, and several were accessible to surgical treatment .…”

Section: Discussionmentioning

confidence: 99%

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Liver transplantation for unresectable colorectal liver metastases: A systematic review

Moris

Tsilimigras

Chakedis

et al. 2017

Journal of Surgical Oncology

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The use of liver transplantation (LT) for liver metastases attempted in the early 1990's was associated with poor perioperative outcomes and unacceptably low overall survival. Recently, there has been renewed interest in LT as a treatment option for colorectal liver metastases (CLM) in countries where organ supply is high. To date, no meticulous analysis about the efficacy, safety and outcomes of LT in CLM patients has been published. We present the first systematic review on the subject.

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Section: Discussionsupporting

confidence: 90%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Liver transplantation for unresectable colorectal liver metastases: A systematic review

Moris

Tsilimigras

Chakedis

et al. 2017

Journal of Surgical Oncology

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“…More recently, the group of Oslo has shown a 60% five-year survival, in 21 patients with colo-rectal metastases (2). Such a survival was better than the one expected on chemotherapy alone (2)(3)(4). However, 95% (20/21) of patients had cancer recurrence, most within the first 18 months after transplantation.…”

Section: To the Editormentioning

confidence: 98%

Liver transplantation for colorectal liver metastasis: Survival without recurrence can be achieved

et al. 2017

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The management of patients with colo-rectal liver metastases has improved significantly over the recent years. However, most patients still cannot undergo complete resection, generally because the location of the metastases within the liver prevents any radical management, and explaining the interest for transplantation. The first attempts were performed in the eighties with poor outcomes, in part due to a high proportion of death not related to the neoplastic disease (1). More recently, the group of Oslo has shown a 60% five-year survival, in 21 patients with colo-rectal metastases (2). Such a survival was better than the one expected on chemotherapy alone (2-4). However, 95% (20/21) of patients had cancer recurrence, most within the first 18 months after transplantation. At present, liver transplantation for colo-rectal metastases remains highly controversial. The potential for long-term disease-free survival needs to be explored, which is the aim of this multi-centric collaborative retrospective study.A total of 12 patients (6 females/6 males) underwent liver transplantation for colo-rectal liver metastasis, at centers affiliated to the "Compagnons Hépato-Bilaires", an association of hepato-pancreato-biliary and transplant surgeons, most trained at the Paul Brousse Hospital, Paris, France under the guidance of Professor H. Bismuth. Median age at transplant was 56 years (Table 1). Patients were managed in Lisbon (n=8), Coimbra (n=2), Paris (n=1), and Geneva (n=1) between October 1995 and October 2015 (date of transplant), and no other patient underwent transplantation for this indication at these respective transplant centers. Data collection was conducted according the relevant ethical standards at each institution. The location of the primary adenocarcinoma was the colon in 11 patients, and the rectum in one. Most primary cancers were T3 on pathology, and many presented between 1 and 3 involved -N1-lymph nodes (two patients were N2 with more than 3 nodes involved, Table 1).For most patients, liver metastases (9/12) were diagnosed within 12 months after the diagnosis of the primary cancer, and were considered as synchronous. When not diagnosed at the same time as the primary, liver metastases were discovered 4, 7, 19, 24 and 29 months after the primary. At the time of transplantation, patients presented a median of 9 liver metastases. Two had lesions >5 cm, of 5.5 and 8 cm. Median CEA level was 16.9 µg/l, and one patients had CEA >200 µg/l, of 314 µg/l.Most (11/12) patients received chemotherapy prior to transplantation. Chemotherapy included irinotecan and oxaliplatin in 9 (82%) patients, and a biological agent in 6 (cetuximab in 2, bevacizumab in 3, and both agents in 1). Another patient was treated by intra-hepatic chemotherapy prior to transplantation. All patients responded to chemotherapy, and none was in progression at the time of the transplantation. The decision to conduct a post-transplant adjuvant chemotherapy was based, at least in the recent years, on the aim to obtain a minimum of four month...

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Complete cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for colorectal peritoneal metastasis in Norway: Prognostic factors and oncologic outcome in a national patient cohort

Frøysnes

Larsen

Spasojevic

et al. 2016

Journal of Surgical Oncology

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Is Liver Transplantation an Option in Colorectal Cancer Patients with Nonresectable Liver Metastases and Progression on All Lines of Standard Chemotherapy?

Abstract: Liver transplantation in nonresectable CLM patients with extensive tumor load and PD on the last line of chemotherapy had extended OS compared with any other treatment option reported in the literature.

Cited by 41 publications

References 21 publications

Liver transplantation for unresectable colorectal liver metastases: A systematic review

Liver transplantation for unresectable colorectal liver metastases: A systematic review

Liver transplantation for colorectal liver metastasis: Survival without recurrence can be achieved

Complete cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for colorectal peritoneal metastasis in Norway: Prognostic factors and oncologic outcome in a national patient cohort

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