Selection criteria related to long-term survival following liver transplantation for colorectal liver metastasis

Am J Transplant. 2020 Feb;20(2):530-537. doi: 10.1111/ajt.15682. Epub 2019 Nov 28.


Patients with nonresectable colorectal cancer receiving palliative chemotherapy have a 5-year overall survival rate of about 10%. Liver transplant provided a Kaplan-Meier-estimated 5-year overall survival of up to 83%. The objective of the study was to evaluate the ability of different scoring systems to predict long-term overall survival after liver transplant. Patients with colorectal cancer with nonresectable liver-only metastases determined by computed tomography (CT)/magnetic resonance imaging/positron emission tomography (PET)-CT scans from 2 prospective studies (SECA-I and -II) were included. All included patients had previously received chemotherapy. PET-CT was performed within 90 days of the liver transplant. Overall survival, disease-free survival, and survival after relapse based on the Fong Clinical Risk Score, total PET liver uptake (metabolic tumor volume), and Oslo Score were compared. At median follow-up of 85 months for live patients, Kaplan-Meier overall survival rates at 5 years were 100%, 78%, and 67% in patients with Fong Clinical Risk Score 0 to 2, metabolic tumor volume-low group, and Oslo Score 0 to 2, respectively. Median overall survival was 101, 68, and 65 months in patients with Fong Clinical Risk Score 0 to 2, metabolic tumor volume-low, and Oslo Score 0 to 2. These selection criteria may be used to obtain 5-year overall survival rates comparable to other indications for liver transplant.

Keywords: cancer/malignancy/neoplasia; cancer/malignancy/neoplasia: metastatic disease; clinical research/practice; clinical trial; liver disease: malignant; liver transplantation/hepatology.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Colorectal Neoplasms
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Liver Neoplasms / diagnostic imaging
  • Liver Neoplasms / mortality
  • Liver Neoplasms / surgery*
  • Liver Transplantation / mortality*
  • Male
  • Middle Aged
  • Neoplasm Metastasis
  • Patient Selection*
  • Prospective Studies