Selection criteria related to long-term survival following liver transplantation for colorectal liver metastasis
Selection criteria related to long-term survival following liver transplantation for colorectal liver metastasis
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DOI：
10.1111/ajt.15682
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发表时间：
2019-11-28
影响因子：
8.8
通讯作者：
Line, Pal-Dag
中科院分区：
文献类型：
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作者：
Dueland, Svein;Grut, Harald;Line, Pal-Dag
接受姑息化疗的不可切除的结直肠癌患者的5年总生存率约为10%。肝移植提供了Kaplan-Meier估计的5年总生存率高达83%。该研究的目的是评估不同评分系统预测肝移植后长期总生存率的能力。纳入了来自2项前瞻性研究（SECA-I和-II）的通过计算机断层扫描（CT）/磁共振成像/正电子发射断层扫描（PET）-CT扫描确定的不可切除的仅肝脏转移的结直肠癌患者。所有入选患者既往均接受过化疗。PET-CT在肝移植后90天内进行。根据Fong临床风险评分、总PET肝脏摄取（代谢肿瘤体积）和奥斯陆评分比较总生存期、无病生存期和复发后生存期。存活患者中位随访时间为85个月，Fong临床风险评分为0 - 2分、代谢性肿瘤体积低和奥斯陆评分为0 - 2分的患者5年Kaplan-Meier总生存率分别为100%、78%和67%。Fong临床风险评分为0 - 2分、代谢性肿瘤体积小、奥斯陆评分为0 - 2分的患者的中位总生存期分别为101、68和65个月。这些选择标准可用于获得与其他肝移植适应症相当的5年总生存率。
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.