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Background <p>Liver transplantation (LT) has emerged as a potential treatment option for selected patients with colorectal liver metastases (CRLM), but existing meta-analyses are limited by heterogeneous populations and mixed treatment modalities.</p> Methods <p>A systematic review and single-arm meta-analysis were conducted in accordance with PRISMA guidelines. Studies reporting outcomes following LT for CRLM were included. Primary outcomes were overall survival (OS) and progression-free survival (PFS) at predefined time points. Secondary outcomes included adverse events. Pooled proportions were calculated using random-effects models with logit transformation and Hartung–Knapp adjustment. Heterogeneity was assessed using the I² statistic.</p> Results <p>Four prospective studies (1 RCT, 3 prospective cohorts) comprising 118 patients were included. Studies were conducted in Norway (SECA-I, <i>n</i> = 21; SECA-II, <i>n</i> = 15), the United Kingdom (<i>n</i> = 50), and a European multicentre RCT (TransMet, <i>n</i> = 32). Median age ranged from 55 to 58 years; all patients had liver-only metastases with resected primary tumors and had received pre-transplant chemotherapy. The pooled 3-year OS was 69% (95% CI, 52–82%; I² = 0.0%), and the pooled 5-year OS was 62% (95% CI, 36–83%; I² = 14.6%). The pooled 3-year PFS was 33% (95% CI, 7–76%), with substantial heterogeneity (I² = 62.8%). The pooled incidence of adverse events was 41% (95% CI, 25–60%; I² = 0.0%). Sensitivity analyses confirmed the robustness of pooled estimates. The retrospective literature also supported the finding that LT can achieve meaningful long-term survival in carefully selected patients.</p> Conclusions <p>In carefully selected patients with CRLM, LT is associated with durable long-term survival and an acceptable safety profile, supporting further prospective evaluation and refinement of selection criteria.</p>

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Durable Survival Outcomes After Liver Transplantation for Colorectal Liver Metastases: A Systematic Review and Single-arm Meta-analysis of Prospective Clinical Trials

  • 期刊论文

  • 发表日期：

    2026年5月29日

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  • Hasnain Wajeeh Saqib,
  • Nadia Siddiq,
  • Mujtaba Moazzam,
  • Muhammad Hamza,
  • Mahad Ahmad,
  • Muzakkir Omer,
  • Talha Khan,
  • Muhammad Faisal Iqbal,
  • Adnara Murad,
  • Rafae Ali Khan,
  • Abu Bakar Hafeez Bhatti

摘要

Background

Liver transplantation (LT) has emerged as a potential treatment option for selected patients with colorectal liver metastases (CRLM), but existing meta-analyses are limited by heterogeneous populations and mixed treatment modalities.

Methods

A systematic review and single-arm meta-analysis were conducted in accordance with PRISMA guidelines. Studies reporting outcomes following LT for CRLM were included. Primary outcomes were overall survival (OS) and progression-free survival (PFS) at predefined time points. Secondary outcomes included adverse events. Pooled proportions were calculated using random-effects models with logit transformation and Hartung–Knapp adjustment. Heterogeneity was assessed using the I² statistic.

Results

Four prospective studies (1 RCT, 3 prospective cohorts) comprising 118 patients were included. Studies were conducted in Norway (SECA-I, n = 21; SECA-II, n = 15), the United Kingdom (n = 50), and a European multicentre RCT (TransMet, n = 32). Median age ranged from 55 to 58 years; all patients had liver-only metastases with resected primary tumors and had received pre-transplant chemotherapy. The pooled 3-year OS was 69% (95% CI, 52–82%; I² = 0.0%), and the pooled 5-year OS was 62% (95% CI, 36–83%; I² = 14.6%). The pooled 3-year PFS was 33% (95% CI, 7–76%), with substantial heterogeneity (I² = 62.8%). The pooled incidence of adverse events was 41% (95% CI, 25–60%; I² = 0.0%). Sensitivity analyses confirmed the robustness of pooled estimates. The retrospective literature also supported the finding that LT can achieve meaningful long-term survival in carefully selected patients.

Conclusions

In carefully selected patients with CRLM, LT is associated with durable long-term survival and an acceptable safety profile, supporting further prospective evaluation and refinement of selection criteria.