Living-related partial liver transplantation in unresectable liver metastatic colorectal cancer. A case report
DOI:
https://doi.org/10.14739/2310-1210.2023.2.271197Keywords:
liver transplantation, sigmoidal cancer, liver cancerAbstract
Aim. The purpose of the article is to study the outcome of using living-related partial liver transplantation in the treatment of unresectable liver metastatic colorectal cancer.
Case report. A woman, born in 1989, applied to the Medical Center Universal Clinic “Oberig” with a diagnosis of stage IV sigmoid colon cancer pT4N2M1 with synchronous liver metastases after sigmoidectomy and adjuvant chemotherapy. The patient underwent surgical intervention to the extent of right-sided hemihepatectomy with total caudate lobectomy, enucleation of metastases from the left liver lobe, cholecystectomy, extended lymphadenectomy, followed by systemic antitumor therapy. Six months later, according to laboratory and instrumental examinations, the progression of the disease was revealed in the form of new metastases development in the left liver lobe. After a thorough examination, a decision was made to treat the patient by living-related partial liver transplantation. On February 16, 2021, the patient underwent orthotopic transplantation of the left liver lobe from a living-related donor. The patient was discharged on the 31st postoperative day in a satisfactory condition. According to a control MRI after discharge, no signs of disease progression were detected. In the post-transplantation period, the patient developed an acute steroid-resistant rejection requiring antiplatelet immunoglobulin prescription. Three months after discharge, the patient was diagnosed with a high stricture of the bilio-biliary anastomosis, so resections of liver segment IV, hepaticocholedochus, and bihepaticojejunostomy on a defunctionalized Roux loop of the small intestine were performed. In the post-transplantation period, no signs of disease progression were detected, and no special antitumor treatment was used.
Conclusions. Liver transplantation is an effective and radical method of treatment for patients with unresectable liver metastatic colorectal cancer.
References
Garajova, I., Balsano, R., Tommasi, C., Dalla Valle, R., Pedrazzi, G., Ravaioli, M., Spallanzani, A., Leonardi, F., Santini, C., Caputo, F., Riefolo, M., Giuffrida, M., & Gelsomino, F. (2020). Synchronous and metachronous colorectal liver metastases: impact of primary tumor location on patterns of recurrence and survival after hepatic resection. Acta bio-medica : Atenei Parmensis, 92(1), e2021061. https://doi.org/10.23750/abm.v92i1.11050
Masuoka, H. C., & Rosen, C. B. (2011). Transplantation for cholangiocarcinoma. Clinics in liver disease, 15(4), 699-715. https://doi.org/10.1016/j.cld.2011.08.004
Mazzaferro, V., Llovet, J. M., Miceli, R., Bhoori, S., Schiavo, M., Mariani, L., Camerini, T., Roayaie, S., Schwartz, M. E., Grazi, G. L., Adam, R., Neuhaus, P., Salizzoni, M., Bruix, J., Forner, A., De Carlis, L., Cillo, U., Burroughs, A. K., Troisi, R., Rossi, M., … Metroticket Investigator Study Group (2009). Predicting survival after liver transplantation in patients with hepatocellular carcinoma beyond the Milan criteria: a retrospective, exploratory analysis. The Lancet. Oncology, 10(1), 35-43. https://doi.org/10.1016/S1470-2045(08)70284-5
Máthé, Z., Tagkalos, E., Paul, A., Molmenti, E. P., Kóbori, L., Fouzas, I., Beckebaum, S., & Sotiropoulos, G. C. (2011). Liver transplantation for hepatic metastases of neuroendocrine pancreatic tumors: a survival-based analysis. Transplantation, 91(5), 575-582. https://doi.org/10.1097/TP.0b013e3182081312
Hoti, E., & Adam, R. (2008). Liver transplantation for primary and metastatic liver cancers. Transplant international, 21(12), 1107-1117. https://doi.org/10.1111/j.1432-2277.2008.00735.x
Fernandez, F. G., Drebin, J. A., Linehan, D. C., Dehdashti, F., Siegel, B. A., & Strasberg, S. M. (2004). Five-year survival after resection of hepatic metastases from colorectal cancer in patients screened by positron emission tomography with F-18 fluorodeoxyglucose (FDG-PET). Annals of surgery, 240(3), 438-450. https://doi.org/10.1097/01.sla.0000138076.72547.b1
Quan, D., Gallinger, S., Nhan, C., Auer, R. A., Biagi, J. J., Fletcher, G. G., Law, C. H., Moulton, C. A., Ruo, L., Wei, A. C., McLeod, R. S., & Surgical Oncology Program at Cancer Care Ontario (2012). The role of liver resection for colorectal cancer metastases in an era of multimodality treatment: a systematic review. Surgery, 151(6), 860-870. https://doi.org/10.1016/j.surg.2011.12.018
Primrose, J. N. (2010). Surgery for colorectal liver metastases. British journal of cancer, 102(9), 1313-1318. https://doi.org/10.1038/sj.bjc.6605659
Foss, A., Adam, R., & Dueland, S. (2010). Liver transplantation for colorectal liver metastases: revisiting the concept. Transplant international, 23(7), 679-685. https://doi.org/10.1111/j.1432-2277.2010.01097.x
Hagness, M., Foss, A., Line, P. D., Scholz, T., Jørgensen, P. F., Fosby, B., Boberg, K. M., Mathisen, O., Gladhaug, I. P., Egge, T. S., Solberg, S., Hausken, J., & Dueland, S. (2013). Liver transplantation for nonresectable liver metastases from colorectal cancer. Annals of surgery, 257(5), 800-806. https://doi.org/10.1097/SLA.0b013e3182823957
Adam, R., de Gramont, A., Figueras, J., Kokudo, N., Kunstlinger, F., Loyer, E., Poston, G., Rougier, P., Rubbia-Brandt, L., Sobrero, A., Teh, C., Tejpar, S., Van Cutsem, E., Vauthey, J. N., Påhlman, L., & of the EGOSLIM (Expert Group on OncoSurgery management of LIver Metastases) group (2015). Managing synchronous liver metastases from colorectal cancer: a multidisciplinary international consensus. Cancer treatment reviews, 41(9), 729-741. https://doi.org/10.1016/j.ctrv.2015.06.006
Bonney, G. K., Chew, C. A., Lodge, P., Hubbard, J., Halazun, K. J., Trunecka, P., Muiesan, P., Mirza, D. F., Isaac, J., Laing, R. W., Iyer, S. G., Chee, C. E., Yong, W. P., Muthiah, M. D., Panaro, F., Sanabria, J., Grothey, A., Moodley, K., Chau, I., Chan, A. C. Y., … Adam, R. (2021). Liver transplantation for non-resectable colorectal liver metastases: the International Hepato-Pancreato-Biliary Association consensus guidelines. The lancet. Gastroenterology & hepatology, 6(11), 933-946. https://doi.org/10.1016/S2468-1253(21)00219-3
NCCN. (2022). Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Guidelines for Colon Cancer Version 1, 2022.
Fasullo, M., Patel, M., Khanna, L., & Shah, T. (2022). Post-transplant biliary complications: advances in pathophysiology, diagnosis, and treatment. BMJ open gastroenterology, 9(1), e000778. https://doi.org/10.1136/bmjgast-2021-000778
Nozawa, H., Sunami, E., Nakajima, J., Nagawa, H., & Kitayama, J. (2012). Synchronous and metachronous lung metastases in patients with colorectal cancer: A 20-year monocentric experience. Experimental and therapeutic medicine, 3(3), 449-456. https://doi.org/10.3892/etm.2011.443
Downloads
Published
How to Cite
Issue
Section
License
Authors who publish with this journal agree to the following terms:- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access)
