Liver transplantation in metastatic colorectal cancer: are we ready for it?

Br J Cancer. 2023 May;128(10):1797-1806. doi: 10.1038/s41416-023-02213-1. Epub 2023 Mar 6.

Abstract

Colorectal cancer (CRC) is a prevalent disease worldwide, with more than 50% of patients developing metastases to the liver. Five-year overall survival remains modest among patients with metastatic CRC (mCRC) treated with conventional therapies however, liver transplantation in a highly selected population can improve clinical outcomes with an impressive 5-year overall survival of 83%. Despite liver transplantation appearing to be a promising therapeutical option for well-selected patients with mCRC with the liver-limited disease, these data come from small monocentric trials which included a heterogeneous population. Currently, several clinical trials are evaluating liver transplantation in this scenario, aiming for a more accurate patient selection by integrating liquid biopsy, tissue profiling, and nuclear medicine to the already known clinical biomarkers that eventually may lead to a survival improvement. In this paper, the clinical outcomes and inclusion criteria from the most relevant clinical trials and clinical series involving liver transplantation in patients with liver-limited disease colorectal cancer are reviewed as well as the trials currently recruiting.

Publication types

  • Review

MeSH terms

  • Colonic Neoplasms*
  • Colorectal Neoplasms* / pathology
  • Humans
  • Liver Neoplasms* / drug therapy
  • Liver Transplantation*
  • Rectal Neoplasms*