Colorectal cancer is the third most common cancer worldwide.  An estimated 106,180 new cases of colon cancer and 44,850 new cases of rectal cancer will be diagnosed in the US in 2022. Many of these patients will develop unresectable colorectal cancer liver metastases (CRLMs). A March 2022 study is the first in North America to demonstrate that a living-donor liver transplant is a viable option for patients who have systemically controlled colorectal cancer and liver tumors that cannot be surgically removed.

“This study proves that transplant is an effective treatment to improve quality of life and survival for patients with colorectal cancer that metastasized to the liver,” said senior study author Dr. Gonzalo Sapisochin, a transplant surgeon at the Ajmera Transplant Centre and the Sprott Department of Surgery at University Health Network (UHN).

The study was conducted at University Health Network, Toronto, Ontario, Canada, the University of Rochester Medical Center (URMC), New York, and the Cleveland Clinic in Ohio. The researchers focused on colorectal cancer in part because it tends to spread to the liver. Some 91 patients were evaluated for the study, 10 (11%) underwent living-donor liver transplant (LDLT). Among the 10 living donors, 7 (70%) were male, and the median age was 40.5 years (range, 27-50 years). Kaplan-Meier estimates for recurrence-free and overall survival at 1.5 years after LDLT were 62% and 100%, respectively.

“This [study] brings hope for patients who have a dismal chance of surviving a few more months,” said Dr. Hernandez-Alejandro, who is also an investigator at the Wilmot Cancer Institute.  “With this, we’re opening opportunities for patients to live longer – and for some of them, to be cured.”

“We have seen very good outcomes with this protocol, with 100 percent survival and 62 percent of patients remaining cancer-free one year and a half after surgery,” said study author Dr. Mark Cattral, surgical director of the Living Donor Liver Program at UHN’s Ajmera Transplant Centre and a surgeon in the Sprott Department of Surgery at UHN. “It is very strong data to support that we can offer this treatment safely and make appropriate use of scarce life-saving organs.”

The full study results are available here.