The emerging role of liver transplantation in metastatic colorectal cancer.

Colorectal cancer has a high global prevalence and is one of the leading causes of cancer-related death. Approximately one quarter of patients with colorectal cancer will develop metastases, most commonly to the liver, with the majority of liver metastases being unresectable and carrying a poor prognosis. Initial results from trials examining liver transplantation as a potentially curative option for isolated liver metastases from colorectal cancer have yielded promising survival outcomes as compared with standard chemotherapy. However, many of the studies are small and non-randomized with highly selected patient cohorts. This treatment option also raises numerous ethical issues, most notably regarding its feasibility in settings with limited liver donor availability. In this review, current evidence examining outcomes following liver transplantation for liver-only colorectal metastases is outlined, along with details surrounding ongoing trials. Ethical and practical considerations surrounding its implementation as a treatment option are also explored.