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The Potential Role of Liver Transplantation as a Treatment Option in Colorectal Liver Metastases

Liver resection is the only potentially curative treatment option in patients with liver metastases from colorectal cancer, but only about 20% of the patients are resectable. Liver transplantation of patients with unresectable liver metastases was attempted in the early era but it was abandoned due...

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Detalles Bibliográficos
Autores principales: Line, Pål-Dag, Hagness, Morten, Dueland, Svein
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5829437/
https://www.ncbi.nlm.nih.gov/pubmed/29623266
http://dx.doi.org/10.1155/2018/8547940
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author Line, Pål-Dag
Hagness, Morten
Dueland, Svein
author_facet Line, Pål-Dag
Hagness, Morten
Dueland, Svein
author_sort Line, Pål-Dag
collection PubMed
description Liver resection is the only potentially curative treatment option in patients with liver metastases from colorectal cancer, but only about 20% of the patients are resectable. Liver transplantation of patients with unresectable liver metastases was attempted in the early era but it was abandoned due to poor survival. During the last decade, several case reports, a controlled pilot study, and a retrospective cohort study indicated that prolonged disease-free survival and overall survival can be obtained in a proportion of these patients. Strict selection criteria have not yet been well defined, but tumor load, response to chemotherapy, pretransplant carcinoembryonic antigen level, and time interval from resection of the primary tumor to transplant are all factors related to outcome. Carefully selected patients may obtain 5-year overall survival that approaches conventional indications for liver transplant. The scarcity of liver grafts is a significant problem, but this can possibly to some extent be addressed by use of extended criteria grafts and novel surgical techniques. There is an increasing interest in liver transplantation in these patients in the transplant community, and currently 4 clinical trials are active and are recruiting.
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spelling pubmed-58294372018-04-05 The Potential Role of Liver Transplantation as a Treatment Option in Colorectal Liver Metastases Line, Pål-Dag Hagness, Morten Dueland, Svein Can J Gastroenterol Hepatol Review Article Liver resection is the only potentially curative treatment option in patients with liver metastases from colorectal cancer, but only about 20% of the patients are resectable. Liver transplantation of patients with unresectable liver metastases was attempted in the early era but it was abandoned due to poor survival. During the last decade, several case reports, a controlled pilot study, and a retrospective cohort study indicated that prolonged disease-free survival and overall survival can be obtained in a proportion of these patients. Strict selection criteria have not yet been well defined, but tumor load, response to chemotherapy, pretransplant carcinoembryonic antigen level, and time interval from resection of the primary tumor to transplant are all factors related to outcome. Carefully selected patients may obtain 5-year overall survival that approaches conventional indications for liver transplant. The scarcity of liver grafts is a significant problem, but this can possibly to some extent be addressed by use of extended criteria grafts and novel surgical techniques. There is an increasing interest in liver transplantation in these patients in the transplant community, and currently 4 clinical trials are active and are recruiting. Hindawi 2018-01-17 /pmc/articles/PMC5829437/ /pubmed/29623266 http://dx.doi.org/10.1155/2018/8547940 Text en Copyright © 2018 Pål-Dag Line et al. https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review Article
Line, Pål-Dag
Hagness, Morten
Dueland, Svein
The Potential Role of Liver Transplantation as a Treatment Option in Colorectal Liver Metastases
title The Potential Role of Liver Transplantation as a Treatment Option in Colorectal Liver Metastases
title_full The Potential Role of Liver Transplantation as a Treatment Option in Colorectal Liver Metastases
title_fullStr The Potential Role of Liver Transplantation as a Treatment Option in Colorectal Liver Metastases
title_full_unstemmed The Potential Role of Liver Transplantation as a Treatment Option in Colorectal Liver Metastases
title_short The Potential Role of Liver Transplantation as a Treatment Option in Colorectal Liver Metastases
title_sort potential role of liver transplantation as a treatment option in colorectal liver metastases
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5829437/
https://www.ncbi.nlm.nih.gov/pubmed/29623266
http://dx.doi.org/10.1155/2018/8547940
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