Department of Translational Research and New Technologies in Medicine, University of Pisa, Pisa; Unit of Medical Oncology 2, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy.
Department of Surgery, Campus Charité Mitte/Campus Virchow-Klinikum, Charité - Universitätsmedizin Berlin Berlin; Berlin Institute of Health at Charité - Universitätsmedizin Berlin, BIH Biomedical Innovation Academy, BIH Charité Clinician Scientist Program, Berlin.
ESMO Open. 2024 Sep;9(9):103669. doi: 10.1016/j.esmoop.2024.103669. Epub 2024 Aug 20.
Pioneer studies suggested that liver transplantation (LT) has the potential to provide long-term survival in patients with liver-limited metastatic colorectal cancer (mCRC) not amenable for surgery of metastases. Evidence, however, was limited to single-arm studies with few patients enrolled and suboptimal selection criteria, with concerns over access to organ availability overcoming the potential efficacy of LT in this setting. Recently, 5-year survival rates with chemotherapy followed by LT (73%) compared with chemotherapy alone (9%) have been demonstrated by the randomized TransMet trial, enrolling 94 definitively unresectable strictly selected liver-limited mCRC patients. These findings should now prompt clinical oncologists to reconsider LT as a valuable option for unresectable liver-limited mCRC patients meeting TransMet criteria, and transplantation agencies to adapt their policies of access to organ donation.
初步研究表明，对于无法手术切除转移灶的肝转移结直肠癌（mCRC）患者，肝移植（LT）有可能提供长期生存。然而，这些证据仅限于少数患者入组的单臂研究，选择标准并不理想，对器官可用性的关注超过了 LT 在这种情况下的潜在疗效。最近，通过随机 TransMet 试验证明，与单独化疗（9%）相比，化疗后接受 LT（73%）的患者 5 年生存率更高，该试验纳入了 94 例严格选择的无法切除的局限性肝转移 mCRC 患者。这些发现现在应该促使临床肿瘤学家重新考虑将 LT 作为符合 TransMet 标准的无法切除的局限性肝转移 mCRC 患者的一种有价值的选择，并且移植机构应调整其获取器官捐献的政策。
