01. The Toronto management of initially unresectable liver metastases from colorectal cancer in a living donor liver transplant program
Recommended Citation
Rajendran L, Claasen MP, Ivanics T, Selzner N, McGilvray I, Cattral M, Ghanekar A, Moulton C, Reichman T, Shwaartz C, Metser U, Burkes R, Winter E, Gallinger S, Sapisochin G. 01. The Toronto management of initially unresectable liver metastases from colorectal cancer in a living donor liver transplant program. Can J Surg 2023; 66(6 Suppl 1):S116.
Document Type
Conference Proceeding
Publication Date
9-20-2023
Publication Title
Can J Surg
Abstract
Background: Living donor liver transplantation (LDLT) is an attractive option for patients with unresectable, bilobar colorectal liver metastases (CRLM). However, it is not available in most centres beyond study protocols. This study describes the interim experience with LDLT for CRLM at a large North American transplant and hepatobiliary centre. Methods: Adults with unresectable CRLM, receiving systemic chemotherapy were recruited into a prospective clinical trial. Data on demographics, referral patterns and clinical characteristics were extracted from October 2016 to February 2023. Patients were divided into 3 groups: transplanted, resected and control (excluded, with continuation of systemic chemotherapy). Overall survival (OS) and recurrence-free survival (RFS) were compared. Results: Eighty-one referred patients were assessed for LDLT. Of these, 7 received transplants, 22 underwent resection and 48 control. All had similar preassessment baseline characteristics. Median time from initial assessment to transplantation was 15.3 months. The control population had significantly worse postassessment OS than the transplanted population (p = 0.002) and resected population (p < 0.001). The median follow-up duration was 21.4 months (resection) and 14.8 months (LDLT). There was no difference in OS between the transplanted and resected populations (1-yr: 100% v. 93.8%; 3-year: 100% v. 43.3%, p = 0.17). However, RFS was superior in the LDLT group (1-yr: 85.7% v. 16.4%; 3-year: 68.6% v. 10.9%, p = 0.015). Conclusion: Most patients with unresectable CRLM referred for LDLT are deemed ineligible for trial inclusion. However, the excellent oncologic outcomes in patients who meet criteria for LDLT support its role in highly selected populations. Future results after the trial’s completion will inform long-term outcomes.
Volume
66
Issue
6 Suppl 1
First Page
S116
