Liver Transplantation for Unresectable Colorectal Cancer Liver Metastases: A Paradigm Change?

Abstract

Historically, colorectal cancer liver metastases have been considered a terminal disease. In the last 20 years, despite dramatic improvements in treatment, especially neoadjuvant therapy and liver resection, the prognosis for patients with nonresectable colorectal carcinoma (NRCRC) liver metastases remains dismal. Colorectal cancer metastases are considered an absolute contraindication for liver transplant because historically results were very poor. Hagness et al. challenged the status quo by revisiting the idea of liver transplantation for NRCRC liver metastases. The estimated overall 5-year survival rate after transplant in their study was 60% compared with only 18% in previous reports. This is a major achievement, considering that chemotherapy alone typically results in a 5-year survival rate of only 5% to 10%.