CANCER, TRANSPLANT

Transplant Oncology Transforms Outcomes for Patients with Unresectable Liver Tumors

March 1, 2022 - Eden McCleskey

Transplant oncology is an emerging field with potential to significantly improve patient survival rates and quality of life. Nowhere is the promise greater than with liver cancer.

Primary liver cancer is the sixth most common cancer in the world and second leading cause of cancer deaths, with a survival rate of approximately 20%. Several factors contribute to the therapeutic challenges of managing the disease, including the complex anatomy of the liver, difficulty detecting liver tumors when they're small and resecting them when they're advanced, and relatively low success rates of systemic therapies.

Surgical removal is often the only way to achieve a cure, but approximately two thirds of liver tumors are considered inoperable. For these patients, a liver transplant represents their best — or only — remaining option.

"Liver transplantation is the only solid organ transplant with noticeable efficacy in curing cancer," Houston Methodist transplant oncologist Dr. Maen Abdelrahim says in a recent review published in the journal Cancers. "By removing the cancerous organ completely and replacing it with a healthy organ, we can overcome the limitations of current surgical techniques and increase the survival rate from 20% to over 80% for patients with primary liver cancer."

For patients with intrahepatic cholangiocarcinoma, Houston Methodist was the first to report a prospective case series showing that neoadjuvant bridging therapy — chemotherapy then liver transplantation — resulted in a five-year survival rate comparable to hepatocellular carcinoma patients who received liver transplants.

Dr. Abdelrahim discusses the evolving field of transplant oncology, expanding eligibility requirements, emerging strategies for adjuvant therapy and immunotherapy and more in a recent Methodology article published by the Houston Methodist Academic Institute.