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Copyright ©The Author(s) 2021.
World J Gastrointest Surg. Dec 27, 2021; 13(12): 1615-1627
Published online Dec 27, 2021. doi: 10.4240/wjgs.v13.i12.1615
Table 1 Published data on liver transplantation for colorectal cancer liver metastasis
Ref.
Year
Center
Period
Patients number
Survival time
Moore et al[12]1964Peter Bent Brigham Hospital, United States September, 1963111 d
Demirleau et al[58]1964Hospital St. Antonie, France January, 196410 d (died of bleeding)
Andersen et al[59]2012Oslo University Hospital, Norway1970124 d (died of fuminating sepsis)
Penn[13]1991Cincinnati Medical Center, United StatesSeptember 1968-March 19918Mortality 11% recurrence rate 70%
Pichlmayr et al[60]1997Hannover Medical School, German 1972-1995411 mo, 8 d, 33 mo
Honoré et al[61]2003University of Liege, Belgium1992110 yr
Kappel et al[9]2006Medical University of Vienna, Austria1983-1994245-yr OS rate 12%-18%
Hoti et al[14]2008European Liver Transplant Registy1968-199550 (including 24 above)1- and 5-yr OS rate were 62% and 18%
Uskudar et al[62]2011The Mount Sinai Hospital, United States2005, 200825 yr (no recurrence); 2 yr (no recurrence)
Kocman et al[63]2011University Hospital Mekur (Croatia)200615 yr (no recurrence)
Hrehoreţ et al[64]2013University of Medicine and Phamarcy Caro Davila, RomaniaJanuary, 2012120 mo post-operation (lung recurrence)
Line et al[46]2015Oslo University Hospital, Norway2014-2017340 d (died of complications); 5.5 yr (no recurrence); 2 yr (recurrent at 12 mo)
Caicedo et al[65]2016ICESI University, ColombiaNovember, 2014119 mo (no recurrence)
Toso et al[66]2017Portugal, Paris, Geneva1995-2015125-yr OS 50% ± 16%, 5-yr PFS 38% ± 15%
Dueland et al[10]2020Olso University Hospital, Norway2006-2012235-yr OS 60%
Yang et al[67]2019Zhongnan Hospital of Wuhan University, China2016134 mo (recurrent at 4 mo)
Lerut et al[68]2019University Hospital Saint-Luc, Belgium1985-2016417 mo (recurrent at 6 mo), 64 mo (recurrent at 47 mo), 32 mo (no), 28 mo (recurrent at 4 mo)
Fernandes et al[69]2019Rio de Janeiro Federal University, BrazilDecember, 20181No prognosis information
Dueland et al[10]2019Oslo University Hospital, Norway2012-2016155-yr OS 83%
Smedman et al[25]2019Oslo University Hospital, Norway2014-201810Median OS 18 mo. Median DFS 4 mo
Coubeau et al[52]2020Cliniques Unviersitaires Saint-Luc20191180 d (no recurrence)
Table 2 Inclusion criteria in some prospective studies on liver transplantation for colorectal cancer liver metastasis
Study
SECA I
SECA II
LIVERTWOHEAL
TRANSMET
Toronto NCT02864485
Inclusion criteria Primary tumor R0 resected; ECOG 0-1; More than 6 wk chemotherapy; No extrahepatic metastasis or recurrence confirmed by PET/CT, bone scanAddition standard: No signs of extra hepatic metastatic disease (except resectable lung metastasis) or local recurrence according to coloscopy, CT or MRI within 12 mo; Chemotherapy response > 10%, If not, TACE or Y-90 response > 20%; More than 12 mo from diagnosis or adjuvant therapyUnresectable CRLM without extrahepatic tumor burden, except resectable pulmonary metastases; Disease regresses or keeps stable after more than 8 wk chemotherapyECOG 0-1; BRAF wild type; Primary tumor R0 resected; No primary recurrence within 12 mo confirmed by coloscopy. Disease stable or regress more than 3 mo with chemotherapy; CEA < 80 ng/mL or decrease ≥ 50%; No extrahepatic metastasis confirmed by CT or PET-CTECOG 0-1; Primary tumor stage is ≤ T4a; More than 6 mo since liver resection; No major vascular invasion; More than 3 mo chemotherapy; Disease regression or stable more than 3 mo; Stable CEA value or decease at all time prior to LT
OutcomeOSOS 10 yrOS 3 yrOS 5 yrOS 5 yr; PFS 5 yr
Table 3 Treatment for unresectable colorectal cancer liver metastasis prior to transplantation
Ref.
Year
Treatment prior to liver transplantation
Liver resection
Local therapy
Systemic therapy
Moore et al[12]1964NRNRNR
Demirleau et al[58]1964NRNRNR
Andersen et al[59]2012NRNRNR
Penn[13]1991NRNRNR
Pichlmayr et al[60]1997NRNRNR
Honoré et al[61]2003YesNoNo
Kappel et al[9]; Hoti et al[14]2006; 2008NRNRNR
Uskudar et al[62]2011YesYes, TACE, HAI. Yes, HAI (causing liver failure)Yes
Kocman et al[63]2011Yes (Two times)NoYes, 1/1
Hrehoreţ et al[64]20I3Yes (ALPPS one stage)Yes, radio therapyYes, FOLFOX AND bevacizumab
Line et al[46]2015No; NRNo; NRYes, 3/3, FLIRI/cetuximab
Caicedo et al[65]2016NoYes, 1/1 RFAYes, 1/1, FOFIRI + cetuximab
Toso et al[66]2017Yes, 10/121/12 RFA11/12, irinotecan, oxaliplatin, cetuximab, bevacizumab
Dueland et al[10]2020Yes, 4/232/23Yes, 23 (1st line, 10 patients; 2nd line, 9 patients; 3rd line, 4 patients)
Yang et al[67]2019NoYes, 1/1; TACE + RFAYes, 1/1, mFOLFOX6 + bevacizumab
Lerut et al[68]2019NoNoYes, 4/4, 5-FU, Oxaliplatin irinotecan, bevacizumab,
Fernandes et al[69]2019YesYesFOLFOX/FOLFIRI
Dueland et al[10]20204/15NRYes, 15/15
Smedman et al[25]20192/102/10 RFAYes, 10 patients (1st line), 10 (2nd line), 3 (3rd line)
Coubeau et al[52]2020NARNARYes, 1/1
Table 4 Adjuvant therapy for recurrence after liver transplantation for unresectable colorectal cancer liver metastasis
Ref.
Overall survival (months)
Die/alive
Recurrence
Adjuvant therapy post recurrence after LT
Yang et al[67]340/1YesChemotherapy
Lerut et al[68]283/1Yes, 4, 6, 47 mo Chemotherapy
Toso et al[66]6/6Median DFS 6 mo5 chemotherapy; 1 radiotherapy
Hagness[39]276/15Median DFS 19 mo11 Chemotherapy; 1 TACE; 7 Radiation therapy; 11 Re-resection
Smedman et al[25]185/5Median DFS 8 mo3 Chemotherapy combined radiation therapy; 2 Chemotherapy; 1 Radiation; 1 Surgery
Dueland et al[10]362/13Median DFS 8 mo6 Surgery; 2 Surgery combined Radiation therapy; 2 Chemotherapy
Hrehoreţ et al[64]200/1Yes, 6 wkChemotherapy
Table 5 Ongoing clinical trials on liver transplantation for colorectal cancer liver metastasis
NCT number
Study name
Year
Type
Patients
Unit, country
Study aims
03494946SECA III2016-2027RCT25Oslo University hospital, NorwayLT vs chemotherapy
02215889No2014-2028Intervention20Oslo University hospital, NorwaySingle arm (segment 2, 3 partial LT)
03488953LIVERTWOHEAL2018-2023Intervention40Jena University Hospital, GermanSingle arm (Living donor liver transplantation with two-staged hepatectomy)
02597348TRASMET2015-2027RCT90Hôpitaux de Paris, FranceLT plus chemotherapy vs chemotherapy
03231722COLT2019-2024Multi-center non-RCTFondazione IRCCS Istituto Nazionale dei Tumori, ItalyLT vs chemotherapy (parallel arm in TRIPLETE trial)
04161092SOULMATE2020-2030Multi-center RCT45Vastra Gotaland Region, SwedenLT (extended criteria graft) vs best alternative therapy