Salvage liver transplantation after resection of colorectal cancer liver metastasis with favorable outcomes: a case report and review of the literature

BMC Gastroenterol. 2021 Apr 27;21(1):191. doi: 10.1186/s12876-021-01778-6.

Abstract

Background: Approximately 50% of patients with colorectal cancer (CRC) develop metastases most commonly in the liver. Liver transplantation (LT) can be used in certain cases of primary liver malignancy or in metastatic diseases, such as Neuroendocrine tumors. However, there are controversies regarding LT as a treatment option for liver metastasis from CRC due to poor outcomes in previously reported cases.

Case presentation: We report a 37-year-old male who underwent resection of the left-sided colon due to cancer and was found to have synchronous liver metastasis for which he received chemotherapy. Later, he underwent a right hepatectomy, which was complicated by insufficient liver remnant function despite the preserved liver perfusion. Therefore, salvage liver transplantation was performed successfully with a good long-term outcome.

Conclusions: Many studies examined the survival and quality of life in patients undergoing liver transplantation for unresectable colorectal liver metastasis; these studies include the SECA Study (secondary cancer) and others with favorable outcomes. We reviewed the literature and compared the outcomes of some of these studies in this article. Our case emphasizes that liver transplantation could be an option for some colon cancer liver metastasis (CLM) patients, specifically, as a salvage procedure. Thus, more research is needed to develop selection criteria for patients who may benefit from liver transplantation.

Keywords: Colorectal liver metastasis; Liver transplant; Overall survival.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Colonic Neoplasms*
  • Colorectal Neoplasms* / surgery
  • Hepatectomy
  • Humans
  • Liver Neoplasms* / surgery
  • Liver Transplantation*
  • Male
  • Quality of Life
  • Retrospective Studies