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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.

Author information

1
Experimental Transplantation and Malignancy Research Group, Division of Surgery, Inflammatory Diseases and Transplantation, Oslo University Hospital.
2
Department of Radiology and Nuclear Medicine, Oslo University Hospital.
3
Section for Transplantation Surgery, Department of Transplantation Medicine, Oslo University Hospital.
4
Institute of Clinical Medicine, University of Oslo.

Abstract

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.

PMID:
31674105
DOI:
10.1111/ajt.15682

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