Transplant for colorectal cancer liver metastases

Whitrock, Jenna N.; Hartman, Stephen J.; Shah, Shimul A.

doi:10.1016/j.surg.2023.01.005

Cited by 4 publications

(4 citation statements)

References 9 publications

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“…One of the first prospective studies evaluating the safety of liver transplants for CRLM was the SECA-I trial ( 1 , 2 ). A 5-year overall survival rate of 60% was observed in this trial, which far outperformed survival with chemotherapy alone ( 3 ). In the SECA-II trial, enrollment was increased, and patients with better prognostic factors, including at least a 10% response to chemotherapy before the transplant, were selected.…”

mentioning

confidence: 76%

“…In transplant oncology, patient selection is an essential component. To ensure appropriate patient selection, a multidisciplinary team including medical oncologists, hepatobiliary and liver transplant surgeons, transplant hepatologists, pathologists, radiologists, and colorectal surgeons should evaluate factors such as tumor histology, molecular criteria, resectability of CRLM, and response to bridging therapy ( 3 ). It is currently possible to determine which patients are most likely to benefit from LT using molecular prognostic markers.…”

mentioning

confidence: 99%

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Liver transplantation for non-resectable colorectal liver metastases

Aziz¹,

Sharif²,

Gribovskaja‐Rupp³

et al. 2023

Hepatobiliary Surg Nutr

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mentioning

confidence: 76%

mentioning

confidence: 99%

Liver transplantation for non-resectable colorectal liver metastases

Aziz¹,

Sharif²,

Gribovskaja‐Rupp³

et al. 2023

Hepatobiliary Surg Nutr

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“…Current guidelines surrounding liver transplant for patients with nonresectable CRLM are limited and are often based on center or trial-specific protocols. Factors such as tumor histology, molecular characteristics, size and location of tumors, radiologic characteristics, patient comorbidities, liver function, and response to bridging therapy are all factors that should be considered when appropriately selecting patients for transplant for CRLM [3,4 ▪ ]. The International Hepato-Pancreato-Biliary Association (IHPBA) released consensus guidelines for use of liver transplant in CRLM in 2021.…”

Section: Current Guidelinesmentioning

confidence: 99%

Expanding MELD exceptions for colorectal liver metastasis: data and policy

Whitrock,

Pratt,

Shah

2024

Current Opinion in Organ Transplantation

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Purpose of review While liver transplant for unresectable colorectal cancer liver metastases (CRLM) has been demonstrated to be a promising treatment in selected patients, the typically low MELD score of these patients and lack of exception points may lead to challenges in receiving a deceased donor liver for transplant. Recent findings Several studies have shown improved outcomes in select patients with CRLM who undergo liver transplant, and several trials are ongoing and will conclude in the next several years. MELD exception points have recently been proposed in qualifying patients with CRLM to help this group obtain more timely quality allografts. Under the current proposal, patients with CRLM would receive a score of the median MELD at transplant (MMaT) for their center minus 20 with a minimum score of 15 in cases where MMaT minus 20 would be less than 15. This would allow them to receive transplants faster without competing unnecessarily with those with greater medical need. Summary Giving MELD exception points to patients with colorectal cancer liver metastases in need of transplant may decrease time on the waitlist and improve outcomes for these patients.

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“…As the second greatest cause of cancer‐related death, colorectal cancer (CRC) ranks third in terms of overall cancer incidence 1 . The high morbidity and mortality rates of CRC are primarily attributed to the disease often being diagnosed at an advanced stage, with limited treatment options available 2 . Although recent advances in diagnostic techniques and treatment strategies have improved the survival rate of CRC patients, the prognosis of those diagnosed at advanced stages remains poor 3 .…”

Section: Introductionmentioning

confidence: 99%

Constructing a personalized prognostic risk model for colorectal cancer using machine learning and multi‐omics approach based on epithelial–mesenchymal transition‐related genes

Zhang,

Fan,

2024

The Journal of Gene Medicine

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The progression and the metastatic potential of colorectal cancer (CRC) are intricately linked to the epithelial–mesenchymal transition (EMT) process. The present study harnesses the power of machine learning combined with multi‐omics data to develop a risk stratification model anchored on EMT‐associated genes. The aim is to facilitate personalized prognostic assessments in CRC. We utilized publicly accessible gene expression datasets to pinpoint EMT‐associated genes, employing a CoxBoost algorithm to sift through these genes for prognostic significance. The resultant model, predicated on gene expression levels, underwent rigorous independent validation across various datasets. Our model demonstrated a robust capacity to segregate CRC patients into distinct high‐ and low‐risk categories, each correlating with markedly different survival probabilities. Notably, the risk score emerged as an independent prognostic indicator for CRC. High‐risk patients were characterized by an immunosuppressive tumor milieu and a heightened responsiveness to certain chemotherapeutic agents, underlining the model's potential in steering tailored oncological therapies. Moreover, our research unearthed a putative repressive interaction between the long non‐coding RNA PVT1 and the EMT‐associated genes TIMP1 and MMP1, offering new insights into the molecular intricacies of CRC. In essence, our research introduces a sophisticated risk model, leveraging machine learning and multi‐omics insights, which accurately prognosticates outcomes for CRC patients, paving the way for more individualized and effective oncological treatment paradigms.

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Transplant for colorectal cancer liver metastases

Cited by 4 publications

References 9 publications

Liver transplantation for non-resectable colorectal liver metastases

Liver transplantation for non-resectable colorectal liver metastases

Expanding MELD exceptions for colorectal liver metastasis: data and policy

Constructing a personalized prognostic risk model for colorectal cancer using machine learning and multi‐omics approach based on epithelial–mesenchymal transition‐related genes

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