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  • Dueland, Svein (author)

Chemotherapy or Liver Transplantation for Nonresectable Liver Metastases From Colorectal Cancer?

  • Article/chapterEnglish2015

Publisher, publication year, extent ...

  • 2015
  • printrdacarrier

Numbers

  • LIBRIS-ID:oai:DiVA.org:uu-252158
  • https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-252158URI
  • https://doi.org/10.1097/SLA.0000000000000786DOI

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  • Language:English
  • Summary in:English

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  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • Objective: The primary objective was to compare overall survival (OS) in patients with colorectal cancer (CRC) with nonresectable liver-only metastases treated by liver transplantation or chemotherapy. Background: CRC is the third most common cancer worldwide. About 50% of patients will develop metastatic disease primarily to the liver and the lung. The majority of patients with liver metastases receive palliative chemotherapy, with a median OS of trial patients of about 2 years, and less than 10% are alive at 5 years. Methods: Patients with nonresectable liver-only CRC metastases underwent liver transplantation in the SECA study (n = 21). Disease-free survival (DFS) and OS of patients included in the SECA study were compared with progression-free survival (PFS) and OS in a similar cohort of CRC patients with liver-only disease included in a first-line chemotherapy study, the NORDIC VII study (n = 47). PFS/DFS and OS were estimated by the Kaplan-Meier method. Results: DFS/PFS in both groups were 8 to 10 months. However, a dramatic difference in OS was observed. The 5-year OS rate was 56% in patients undergoing liver transplantation compared with 9% in patients starting first-line chemotherapy. The reason for the large difference in OS despite similar DFS/PFS is likely different metastatic patterns at relapse/progression. Relapse in the liver transplantation group was often detected as small, slowly growing lung metastases, whereas progression of nonresectable liver metastases was observed in the chemotherapy group. Conclusions: Compared with chemotherapy, liver transplantation resulted in a marked increased OS in CRC patients with nonresectable liver-only metastases.

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Added entries (persons, corporate bodies, meetings, titles ...)

  • Guren, Tormod K. (author)
  • Hagness, Morten (author)
  • Glimelius, BengtUppsala universitet,Enheten för onkologi(Swepub:uu)bengglim (author)
  • Line, Pal-Dag (author)
  • Pfeiffer, Per (author)
  • Foss, Aksel (author)
  • Tveit, Kjell M. (author)
  • Uppsala universitetEnheten för onkologi (creator_code:org_t)

Related titles

  • In:Annals of Surgery261:5, s. 956-9600003-49321528-1140

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