Multimodality neoadjuvant downstaging therapy before liver transplantation for colorectal liver metastasis: Real-world data from the Cleveland Clinic.

Puntos clave

• This research aims to evaluate the impact of multimodality neoadjuvant therapy on outcomes for patients undergoing liver transplantation for colorectal liver metastasis.
• 23 patients entered the protocol; 22 underwent liver transplantation following the Cleveland Clinic down-staging protocol.
• Interventions included intensive locoregional therapy and systemic chemotherapy, assessed using FDG PET-CT, ctDNA, and CEA.
• Follow-up included evaluation of metabolic activity pre- and post-liver transplantation.
• At a median follow-up of 1.6 years, 20 (91%) of patients remain alive and 18 (82%) are recurrence-free.
• Median recurrence-free survival was 5.4 years (95% CI=3.52-7.36) and overall survival was 6.72 years (95% CI=5.34-8.00).
• Pre-LT ctDNA negativity correlated with non-viable tumors on explant (p=0.028).