Liver transplantation may be better for colorectal cancer that has spread to liver
CANCER DIGEST – Aug. 10, 2024 – For patients whose colorectal cancer is under control, but have tumors in their livers, liver transplantation appears to offer longer survival without cancer progression compared to other treatment options, a study in the July 2024 journal JAMA Surgery shows.
Colorectal cancer often spreads to the liver complicating the treatment options. While the colorectal cancer is often controlled with surgery, removal of liver tumors may not be possible for some. Many such patients are faced with standard therapy using chemotherapy or removal of part of the liver.
Researchers led by Matthew Byrne, MD and Roberto Hernandez-Alejandro, MD at the University of Rochester Medical Center in New York analyzed the outcomes of 33 patients who had successful surgery for colorectal cancer, but also had liver tumors that could not be surgically removed.
All 33 patients were eligible for liver transplants, but only 20 chose transplantation, the other 13 underwent chemotherapy or partial liver removal, or other therapies.
After following all 33 patients over three years, the researchers found that in the liver transplantation group, 90 percent survived one year without their cancer progressing compared to 42 percent of those whose liver tumors were treated with other options. After two years 73 percent of the transplantation group remained progression free, and after three years 42 percent remained cancer progression free. That compared to only 10 percent of those treated with other options after two and three years.
The transplantation group also had higher overall survival with 90 percent surviving after three years, compared to 73 percent of those in the other therapies group.
“Unfortunately, liver transplantation is not for every single patient who has advanced metastatic disease in the liver,” said Hernandez-Alejandro in a press release. “The way we can have good results and help these patients is by establishing strict criteria based on tumor biology, the behavior of these tumors, how well they respond to chemotherapy. We only perform transplants for patients who are likely to have a good outcome.”
The University of Rochester Medical Center is known for its organ transplantation program, and has the largest liver transplant center in the country and the second largest liver transplant center in the world.
While this study provides good evidence that liver transplantation may be superior to other therapies for colorectal cancer that has spread to the liver, larger clinical trials will be necessary to establish the effectiveness of liver transplantation across a broader cross section of patients and transplantation centers according to the researchers.
Source: University of Rochester Medical Center press release
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