大肠癌肝转移的移植治疗。

IF 1.8 4区 医学 Q3 TRANSPLANTATION Current Opinion in Organ Transplantation Pub Date : 2024-02-01 Epub Date: 2023-11-23 DOI:10.1097/MOT.0000000000001126
Pål-Dag Line, Svein Dueland
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引用次数: 0

摘要

综述目的:肝移植已成为不可切除的结直肠肝转移患者的一种可能的治疗方法,但关于最佳选择标准和可接受的结果仍然存在争议。最新发现:在最大队列中的单因素分析证实,异时性疾病、奥斯陆评分= 0-1、代谢肿瘤体积(MTV)小于70 cm3和肿瘤负担评分小于9是良好总生存结局的积极预测因素。最近的一些试验可能表明,在移植评估中,技术可切除性并不是高肿瘤负荷和预后评分良好的患者的有效排除标准。循环DNA技术和液体活检的最新发展可能在未来的患者选择和监测中发挥作用。总结:移植的评估需要多学科的参与,不应该延迟到传统的肿瘤治疗失败。需要更大的数据集来完善结肠直肠癌肝转移(CRLM)患者肝移植的选择标准。
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Transplantation for colorectal liver metastasis.

Purpose of review: Liver transplantation has emerged as a possible treatment for selected patients with nonresectable colorectal liver metastasis, but controversy still exists regarding optimal selection criteria and acceptable outcomes.

Recent findings: Univariate analysis in the largest cohorts confirms that metachronous disease, Oslo score = 0-1, metabolic tumor volume (MTV) less than 70 cm 3 , and tumor burden score less than 9 are positive predictive factors for good overall survival outcomes. Some recent trials might suggest that technical resectability is not a valid exclusion criterion for patients with high tumor load and favorable prognostic scores in the transplant evaluation. Recent developments in circulation DNA technology and liquid biopsy may play a future role in the selection and monitoring of patients.

Summary: Evaluation for transplant needs multidisciplinary involvement and should not be delayed until the failure of conventional oncological therapy. Larger data sets are needed to refine the selection criteria for liver transplantation in colorectal liver metastasis (CRLM).

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来源期刊
CiteScore
4.10
自引率
4.50%
发文量
124
审稿时长
6-12 weeks
期刊介绍: ​​​​​​Current Opinion in Organ Transplantation is an indispensable resource featuring key, up-to-date and important advances in the field from around the world. Led by renowned guest editors for each section, every bimonthly issue of Current Opinion in Organ Transplantation delivers a fresh insight into topics such as stem cell transplantation, immunosuppression, tolerance induction and organ preservation and procurement. With 18 sections in total, the journal provides a convenient and thorough review of the field and will be of interest to researchers, surgeons and other healthcare professionals alike.
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