Liver Transplantation With Two-stage Liver Resection in Unresectable Liver Cancer or Metastases (LTLR-LC)

Colon cancer and primary liver cancer are common malignant tumors with low survival rate worldwide, and unresectable primary liver cancer and colon cancer liver metastases have worse prognosis.Liver transplantation is a treatment option for the above-mentioned patients and is expected to improve the prognosis of the patients, but the biggest problem faced by such patients is the shortage of donor livers. Recently, a new surgical modality, resection and partial liver segment 2-3 transplantation with delayed total hepatectomy (RAPID), can greatly alleviate these problems.Based on clinical surgical experience, our center proposes and designs a clinical study of adjuvant liver transplantation combined with two-stage hepatectomy in the treatment of patients with unresectable primary liver cancer or colorectal cancer liver metastases. By improvement of RAPID operation, the safety and efficacy of this treatment method in patients with unresectable primary liver cancer or colorectal cancer liver metastases were evaluated.

Inclusion Criteria:Patients with unresectable primary liver cancer or liver metastases from colorectal cancer, first-line chemotherapy for 6-8 weeks after diagnosis, tumor shrinkage or no obvious progression;No other abdominal metastasis except the liver or there are 1-3 resectable lung metastases;Child grade A or B preoperatively, able to tolerate subsequent surgical optionsExclusion Criteria:Extrahepatic tumor burden (except for resectable lung metastases) and/or macrovascular tumor infiltrationTumor progression during chemotherapy or important comorbidities that affect surgeryUncorrectable cardiopulmonary disease with high surgical riskAnatomical abnormalities that preclude liver transplantationPersistent non-compliance with medical careCombined with other diseases such as AIDS that affect surgery or tumor progression