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Chemotherapy or Liver Transplantation for Nonresectable Liver Metastases From Colorectal Cancer?
- Dueland, Svein (author)
- Guren, Tormod K. (author)
- Hagness, Morten (author)
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- Line, Pal-Dag (author)
- Pfeiffer, Per (author)
- Foss, Aksel (author)
- Tveit, Kjell M. (author)
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- (creator_code:org_t)
- 2015
- 2015
- English.
- In: Annals of Surgery. - 0003-4932 .- 1528-1140. ; 261:5, s. 956-960
- Journal article (peer-reviewed)
Abstract
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- 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.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
Keyword
- chemotherapy
- colorectal cancer
- liver metastases
- liver transplantation
- overall survival
Publication and Content Type
- ref (subject category)
- art (subject category)
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- Dueland, Svein
- Guren, Tormod K.
- Hagness, Morten
- Glimelius, Bengt
- Line, Pal-Dag
- Pfeiffer, Per
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- Foss, Aksel
- Tveit, Kjell M.
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- Uppsala University
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