Colon Rectal Liver Metastases: The Role of the Liver Transplantation in the Era of the Transplant Oncology and Precision Medicine

Michele Finotti; Alessandro Vitale; Enrico Gringeri; Francesco Enrico D'Amico; Riccardo Boetto; Alessandra Bertacco; Sara Lonardi; Francesca Bergamo; Paolo Feltracco; Umberto Cillo

doi:10.3389/fsurg.2021.693387

Colon Rectal Liver Metastases: The Role of the Liver Transplantation in the Era of the Transplant Oncology and Precision Medicine

Front Surg. 2021 Jul 20:8:693387. doi: 10.3389/fsurg.2021.693387. eCollection 2021.

Affiliations

¹ University of Padova, Transplantation and Hepatobiliary Surgery, Padua, Italy.
² Unit of Oncology 1, Department of Oncology, Veneto Institute of Oncology IOV - Istituto di Ricovero e Cura a Carattere Scientifico, Padua, Italy.
³ Anesthesia and Intensive Care Unit, Azienda Ospedaliera di Padova, Padua, Italy.

Abstract

The development of liver metastases in colon rectal cancer has a strong impact on the overall survival (OS) of the patient, with a 5-year survival rate of 5% with palliative treatment. Surgical resection combined with pharmacological treatment can achieve a 5-year OS rate of 31-58%. However, in only 20% of patients with colon rectal liver metastases (CRLMs), liver resection is feasible. In highly selected patients, recent trials and studies proved that liver transplantation (LT) for non-resectable CRLM is a surgical option with an excellent long-term OS. The paper aims to review the indications and outcome of LT for CRLMs, with a special focus on immunosuppressive therapy and the management of local and extrahepatic recurrence after LT.

Keywords: immunosopressive therapy; liver resection; prioritization; recurrence; transplant benefit.

Publication types

Review