Shafik Dawood Z, Brown ZJ, Munir MM, Waqar U, Rawicz-Pruszynski K, Endo Y, Gajjar A, Schenk A, Pawlik TM
INTRODUCTION : Liver transplantation for non-resectable colorectal liver metastasis (NRCRLM) has become accepted for select patients meeting strict inclusion criteria. Advancements in patient selection and understanding of cancer biology may expand benefits to patients with CRLM. In this meta-analysis, we sought to assess survival outcomes, recurrence patterns and quality of life (QoL) following liver transplantation (LT) for CRLM.
METHODS : PubMed, Embase and Scopus databases were searched. Random-effect meta-analysis was conducted to obtain pooled overall survival, and disease-free survival rates, as well as compare QoL from baseline. Continuous data were analyzed, and standardized mean difference (SMD) were reported.
RESULTS : Overall, 16 studies (403 patients, 58.8% male) were included. The pooled 1- 3- and 5- year OS following LT for NRCRLM were 96% (CI-92-99%), 77% (CI-62-89%) and 53% (CI-45-61%) respectively. Moreover, the pooled 1-, 3- and 5-year DFS were 58% (CI-43-72%), 33% (CI-9-61%) and 13% (CI-4-27%), respectively. Overall, 201 patients (49.8%) experienced recurrence during the follow-up period with the lungs being the most common site (45.8%). There was no significant difference in physical and emotional functioning, fatigue, and pain components of QoL at 6 months following LT compared with baseline (all p>0.05).
CONCLUSION : LT for NRCRLM demonstrates good OS outcomes with no differences in QoL of patients at 6 months following transplantation. Transplantation may represent a viable treatment option for NRCRLM.