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Am J Transplant. 2019 Nov 1. doi: 10.1111/ajt.15682. [Epub ahead of print]

Selection criteria related to long term survival following liver transplantation for colorectal liver metastasis.

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Experimental Transplantation and Malignancy Research Group, Division of Surgery, Inflammatory Diseases and Transplantation, Oslo University Hospital.
Department of Radiology and Nuclear Medicine, Oslo University Hospital.
Section for Transplantation Surgery, Department of Transplantation Medicine, Oslo University Hospital.
Institute of Clinical Medicine, University of Oslo.


Patients with non-resectable colorectal cancer receiving palliative chemotherapy has a 5-year overall survival of about 10%. Liver transplantation provided Kaplan-Meier estimated 5-year overall survival of up to 83%. The objective of the study was to evaluate the ability of different scoring systems to warrant long term overall survival after liver transplantation. Colorectal cancer patients with non-resectable liver only metastases determined by CT/MRI/PET-CT scans from two prospective studies (SECA-I and II) were included. All included patients had previously received chemotherapy. PET/CT was performed within 90 days of the liver transplantation. Overall survival, disease-free survival and survival after relapse based on the following scoring systems; Fong Clinical Risk Score, total PET liver uptake (metabolic tumor volume) and Oslo Score were compared. At median follow-up of 85 months of patients alive, Kaplan-Meier overall survival at five years were 100%, 78% and 67%, in patients with Fong Clinical Risk Score 0-2, metabolic tumor volume-low group and Oslo Score 0-2, respectively. Median overall survival was 101 months, 68 months and 65 months in Fong Clinical Risk Score 0-2, metabolic tumor volume-low and Oslo Score 0-2. These selection criteria may be used to obtain 5-year overall survival rates comparable to other indications for liver transplantation.


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