当前位置：
X-MOL 学术
›
Hepatology
›
论文详情
Our official English website, www.x-mol.net, welcomes your
feedback! (Note: you will need to create a separate account there.)
Liver transplantation for primary and secondary liver tumours. patient-level meta-analyses compared to unos conventional indications
Hepatology ( IF 12.9 ) Pub Date : 2024-10-28 , DOI: 10.1097/hep.0000000000001129 Ruben Ciria, Tommy Ivanics, Daniel Aliseda, Marco Claasen, Felipe Alconchel, Felipe Gaviria, Javier Briceño, Giammauro Berardi, Fernando Rotellar, Gonzalo Sapisochin
Hepatology ( IF 12.9 ) Pub Date : 2024-10-28 , DOI: 10.1097/hep.0000000000001129 Ruben Ciria, Tommy Ivanics, Daniel Aliseda, Marco Claasen, Felipe Alconchel, Felipe Gaviria, Javier Briceño, Giammauro Berardi, Fernando Rotellar, Gonzalo Sapisochin
Background & Aims: Liver transplant (LT) for Transplant Oncology (TO) indications is being slowly adopted worldwide and has been recommended to be incorporated cautiously due to concerns on mid-long term survival and its impact on waiting list. Approach & Results: We conducted four systematic reviews of all series on TO indications (intrahepatic (iCC) and perihilar cholangiocarcinoma (phCC)), liver metastases from neuroendocrine tumors (NET) and colorectal cancer (CRLM)) and compared them using patient-level meta-analyses to data obtained from UNOS database considering conventional daily-practice indications. Secondary analyses were done for specific selection criteria (Mayo-like protocols for phCC, SECA-2 for CRLM and Milan criteria for NET). A total of 112.014 LT were analyzed from 2005 to 2020 from the UNOS databases and compared with 345, 721, 494 and 103 patients obtained from meta-analyses on iCC and phCC, and liver metastases from NET and CRLM, respectively. Five-years overall survival was 53,3%, 56,4%, 68,6% and 53,8%, respectively. In Mantel-Cox one-to-one comparisons, survival of TO indications was superior to combined LT, second and third LT and and not statistically significant different to LT in recipients>70 years and high BMI. Conclusions: Liver transplantation for TO indications has adequate 5-years survival rates, mostly when performed under the selection criteria available in literature (Mayo-like protocols for phCC, SECA-2 for CRLM and Milan for NET). Despite concerns on its impact on waiting list, some other LT indications are being performed with lower survival. These oncological patients should be given the opportunity to have a definitive curative therapy within validated criteria.
更新日期：2024-10-28
京公网安备 11010802027423号