4.2 Review

New Insights in the Setting of Transplant Oncology

Journal

MEDICINA-LITHUANIA
Volume 59, Issue 3, Pages -

Publisher

MDPI
DOI: 10.3390/medicina59030568

Keywords

peri-hilar cholangiocarcinoma; intrahepatic cholangiocarcinoma; colorectal liver metastases; neoadjuvant chemotherapy; liver transplantation

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This paper reviews the recent developments in liver transplantation (LT) for unresectable colorectal liver metastases (CRLM) and cholangiocellular carcinoma (CCA), and suggests that integration of LT with (neo)-adjuvant chemotherapy, radiotherapy, or locoregional treatments can effectively cure selected patients. However, further advances in diagnosis, treatment protocols, and donor-to-recipient matching are needed to better define the oncological indications for transplantation. Prospective, multicenter trials are still required to study these advances and their impact on outcomes.
Background and Objectives: Liver transplantation (LT) is the best strategy for curing several primary and secondary hepatic malignancies. In recent years, growing interest has been observed in the enlargement of the transplant oncology indications. This paper aims to review the most recent developments in the setting of LT oncology, with particular attention to LT for unresectable colorectal liver metastases (CRLM) and cholangiocellular carcinoma (CCA). Materials and Methods: A review of the recently published literature was conducted. Results: Growing evidence exists on the efficacy of LT in curing CRLM and peri-hilar and intrahepatic CCA in well-selected patients when integrating this strategy with (neo)-adjuvant chemotherapy, radiotherapy, or locoregional treatments. Conclusion: For unresectable CCA and CRLM management, several prospective protocols are forthcoming to elucidate LT's impact relative to alternative therapies. Advances in diagnosis, treatment protocols, and donor-to-recipient matching are needed to better define the oncological indications for transplantation. Prospective, multicenter trials studying these advances and their impact on outcomes are still required.

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