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Liver metastases constitute a major challenge for the management of advanced colorectal cancer. But a real glimmer of hope seems to be emerging thanks to the TransMet study, carried out by the team from the hepato-biliary center at Paul-Brousse hospital and the University of Paris-Saclay, in collaboration with 20 European centers. This study shows that liver transplantation, combined with chemotherapy, could well be a game-changer.
Survival increased 8-fold thanks to liver transplantation
Colorectal cancer with unresectable liver metastases is a poor prognosis factor. However, the TransMet study offers promising results. The figures speak for themselves: among the 74 patients treated according to the defined protocols, 73% of those who benefited from a liver transplant survived after five years, compared to only 9% in the group treated only with chemotherapy. A result that cannot leave one indifferent.
Professor René Adam, who coordinated the study, emphasizes that this therapeutic strategy could be potentially curative for these patients, until now deprived of real long-term options. But how did we get there?
42% of patients in complete remission
The TransMet study included 94 patients aged 18 to 65, all with unresectable liver metastases from colorectal cancer. These metastases were stabilized by at least three months of chemotherapy. The patients were divided into two groups: one receiving liver transplantation followed by chemotherapy, the other receiving chemotherapy only.
The objective was simple: to compare the five-year overall survival in these two groups. The result? A clear victory for transplantation. Beyond the survival rate, 42% of patients who received a transplant were in complete remission after a median follow-up of 50 months, compared to only 3% in the chemotherapy group. Figures that push us to rethink the management of this type of cancer.
Similar complications, but very different perspectives
The study also assessed complications related to the two treatments. Highlight: the rate of serious complications was similar between the two groups, demonstrating that liver transplantation, often perceived as risky, is in reality an option just as safe as chemotherapy alone. But with a much greater impact on survival and quality of life.
These results, published in the prestigious journal The Lancettherefore shed light on this hitherto little-exploited strategy. Professor Adam and his colleagues therefore call for a re-evaluation of current recommendations in oncology. Liver transplantation, combined with chemotherapy, could well become a standard in the treatment of unresectable liver metastases.
Towards a paradigm shift in oncology?
The TransMet study shows that liver transplantation is no longer just a hope for patients with liver metastases, but a viable and potentially curative solution. These results could only be the beginning of a new era in the treatment of metastatic cancers.