Трансплантация печени при метастатическом колоректальном раке (клиническое наблюдение)

Трансплантация печени при метастазах колоректального рака является противоречивым лечебным мероприятием и не рекомендована в клинических практических руководствах. В статье представлено первое в России клиническое наблюдение трансплантации печени от посмертного донора молодой пациентке с множественными билобарными нерезектабельными метастазами рака ободочной кишки в печени. Заболевание не прогрессирует в течение 10 мес на фоне иммуносупрессивной терапии (эверолимус) и адъювантного лечения. В кратком литературном обзоре освещено состояние проблемы и место трансплантации печени в лечении метастатического колоректального рака.

1. Злокачественные новообразования в России в 2017 году. Под ред. Каприна А.Д., Старинского В.В., Петровой Г.В. М.: МНИОИ им. П.А. Герцена - филиал ФГБУ “НМИЦ радиологии” Минздрава России, 2018. 250 с.

2. Kanas G.P., Taylor A., Primrose J.N., Langeberg W.J., Kelsh M.A., Mowat F.S., Alexander D.D., Choti M.A., Poston G. Survival after liver resection in metastatic colorectal cancer: review and meta-analysis of prognostic factors. Clin. Epidemiol. 2012; 4: 283-301. DOI: 10.2147/CLEP.S34285.

3. Mody K., Baldeo C., Bekaii-Saab T. Antiangiogenic therapy in colorectal cancer. Cancer J. 2018; 24 (4): 165-170. DOI: 10.1097/PPO.0000000000000328.

4. Hecht J.R., Mitchell E., Chidiac T., Scroggin C., Hagenstad C., Spigel D., Marshall J., Cohn A., McCollum D., Stella P., Deeter R., Shahin S., Amado R.G. A randomized phase IIIB trial of chemotherapy, bevacizumab, and panitumumab compared with chemotherapy and bevacizumab alone for metastatic colorectal cancer. J. Clin. Oncol. 2009; 27 (5): 672-680. DOI: 10.1200/JCO.2008.19.8135.

5. Bennouna J., Sastre J., Arnold D., Osterlund P., Greil R., Van Cutsem E., von Moos R., Vieitez J.M., Bouche O., Borg C., Steffens C.C., Alonso-Orduna V., Schlichting C., Reyes-Rivera I., Bendahmane B., Andre T., Kubicka S.; ML18147 Study Investigators. Continuation of bevacizumab after first progression in metastatic colorectal cancer (ML18147): a randomised phase 3 trial. Lancet Oncol. 2013; 14 (1): 29-37. DOI: 10.1016/S1470-2045(12)70477-1.

6. Broadbridge V.T., Karapetis C.S., Price T.J. Cetuximab in metastatic colorectal cancer. Expert Rev. Anticancer. Ther. 2012; 12 (5): 555-565. DOI: 10.1586/era.12.25.

7. Starzl T.E., Fung J.J. Themes of liver transplantation. Hepatology. 2010; 51 (6): 1869-1884. DOI: 10.1002/hep.23595.

8. Muhlbacher F., Huk I., Steininger R., Gnant M., Gotzinger P., Wamser P., Banhegyi C., Piza F. Is orthotopic liver transplantation a feasible treatment for secondary cancer of the liver? Transplant. Proc. 1991; 23 (1Pt2): 1567-1568.

9. Penn I. Hepatic transplantation for primary and metastatic cancers of the liver. Surgery. 1991; 110 (4): 726-734.

10. European Association for the Study of the Liver. EASL Clinical Practice Guidelines: Liver transplantation. J. Hepatol. 2016; 64 (2): 433-485. DOI: 10.1016/j.jhep.2015.10.006.

11. Martin P., DiMartini A., Feng S., Brown R.Jr., Fallon M. Evaluation for liver transplantation in adults: 2013 practice guideline by the American Association for the Liver Diseases and the American Society of Transplantation. Hepatology. 2014; 59 (3): 1144-1465.

12. Hoti E., Adam R. Liver transplantation for primary and metastatic liver cancers. Transpl. Int. 2008; 21 (12): 1107-1117. DOI: 10.1111/j.1432-2277.2008.00735.x.

13. Uskudar O., Raja K., Schiano T.D., Fiel M.I., del Rio Martin J., Chang C. Liver transplantation is possible in some patients with liver metastasis of colon cancer. Transplant. Proc. 2011; 43 (5): 2070-2074. DOI: 10.1016/j.transproceed.2011.03.052.

14. Kocman B., Mikulic D., Jadrijevic S., Poljak M., Kocman I., Gasparov S., Kanizaj T.F., Cvrlje V.C. Long-term survival after living-donor liver transplantation for unresectable colorectal metastases to the liver: case report. Transplant. Proc. 2011; 43 (10): 4013-4015. DOI: 10.1016/j.transproceed.2011.09.065.

15. Caicedo L.A., Buitrago D., Thomas L.S., Villegas J.I., Duque M., Serrano O., Arrunategui A.M., Restrepo J.G., Echeverri G.J. Liver transplantation for unresectable metastases from colon adenocarcinoma. Case Rep. Gastroenterol. 2017; 10 (3): 808-813. DOI: 10.1159/000454984.

16. Foss A., Adam R., Dueland S. Liver transplantation for colorectal liver metastases: revisiting the concept. Transpl. Int. 2010; 23 (7): 679-685. DOI: 10.1111/j.1432-2277.2010.01097.x.

17. Hagness M., Foss A., Line P.D., Scholz T., J0rgensen P.F., Fosby B., Boberg K.M., Mathisen O., Gladhaug I.P., Egge T.S., Solberg S., Hausken J., Dueland S. Liver transplantation for nonresectable liver metastases from colorectal cancer. Ann. Surg. 2013; 257 (5): 800-806. DOI: 10.1097/SLA.0b013e3182823957.

18. Niemi G., Breivik H. Epidural fentanyl markedly improves thoracic epidural analgesia in a low-dose infusion of bupivacaine, adrenaline and fentanyl. A randomized, double-blind crossover study with and without fentanyl. Acta Anaesthesiol. Scand. 2001; 45 (2): 221-232.

19. Makuuchi M., Takayasu K., Takuma T., Yamazaki S., Hasegawa H., Nishimura S., Shimamura Y. Preoperative transcatheter embolization of the portal venous branch for patients receiving extended lobectomy due to the bile duct carcinoma. J. Jpn. Soc. Clin. Surg. 1984; 45 (12): 14-20.

20. Adam R., Laurent A., Azoulay D., Castaing D., Bismuth H. Two-stage hepatectomy: a planned strategy to treat irresectable liver tumors. Ann. Surg. 2000; 232 (6): 777-785.

21. Schnitzbauer A.A., Lang S.A., Goessmann H., Nadalin S., Baumgart J., Farkas S.A., Fichtner-Feigl S., Lorf T, Goralcyk A., Horbelt R., Kroemer A., Loss M., Rummele P., Scherer M.N., Padberg W., Konigsrainer A., Lang H., Obed A., Schlitt H.J. Right portal vein ligation combined with in situ splitting induces rapid left lateral liver lobe hypertrophy enabling 2-staged extended right hepatic resection in small-for-size settings. Ann. Surg. 2012; 255 (3):405-414. DOI:10.1097/SLA.0b013e31824856f5.

22. Gall T.M., Sodergren M.H., Frampton A.E., Fan R., Spalding D.R., Habib N.A., Pai M., Jackson J.E., Tait P., Jiao L.R. Radio-frequency-assisted liver partition with portal vein ligation (RALPP) for liver regeneration. Ann. Surg. 2015; 261 (2): e45-46. DOI: 10.1097/SLA.0000000000000607.

23. Bismuth H., Adam R., Levi F., Farabos C., Waechter F., Castaing D., Majno P., Engerran L. Resection of nonresectable liver metastases from colorectal cancer after neoadjuvant chemotherapy. Ann. Surg. 1996; 224 (4): 509-520.

24. Tomasello G., Petrelli F., Ghidini M., Russo A., Passalacqua R., Barni S. FOLFOXIRI plus bevacizumab as conversion therapy for patients with initially unresectable metastatic colorectal cancer: a systematic review and pooled analysis. JAMA Oncol. 2017; 3 (7): e170278. DOI: 10.1001/jamaoncol.2017.0278.

25. Masuda T., Margonis G.A., Andreatos N., Wang J., Warner S., Mirza M.B., Angelou A., Damaskos C., Garmpis N., Sasaki K., He J., Imai K., Yamashita Y.I., Wolfgang C.L., Baba H., Weiss M.J. Combined hepatic resection and radio-frequency ablation for patients with cancer liver metastasis: a viable option for patients with a large number of tumors. Anticancer Res. 2018; 38 (11): 6353-6360. DOI: 10.21873/anticanres.

26. Andres A., Oldani G., Berney T., Compagnon P., Line P.D., Toso C. Transplantation for colorectal metastases: on the edge of a revolution. Transl. Gastroenterol. Hepatol. 2018; 3: 74. DOI: 10.21037/tgh.2018.08.04.

27. Toso C., Pinto Marques H., Andres A., Castro Sousa F., Adam R., Kalil A., Clavien P.A., Furtado E., Barroso E., Bismuth H.; Compagnons Hepato-Biliaires Group. Liver transplantation for colorectal liver metastasis: survival without recurrence can be achieved. Liver Transpl. 2017; 23 (8): 1073-1076. DOI: 10.1002/lt.24791.

28. Vivarelli M., Cucchetti A., La Barba G., Ravaioli M., Del Gaudio M., Lauro A., Grazi G.L., Pinna A.D. Liver transplantation for hepatocellular carcinoma under calcineurin inhibitors: reassessment of risk factors for tumor recurrence. Ann. Surg. 2008; 248 (5): 857-862. DOI: 10.1097/SLA.0b013e3181896278.

29. Seeliger H., Guba M., Kleespies A., Jauch K.W., Bruns C.J. Role of mTOR in solid tumor systems: a therapeutical target against primary tumor growth, metastases, and angiogenesis. Cancer Metastasis Rev. 2007; 26 (3-4): 611-621. DOI: 10.1007/s10555-007-9077-8.

30. Hagness M., Foss A., Egge T.S., Dueland S. Patterns of recurrence after liver transplantation for nonresectable liver metastases from colorectal cancer. Ann. Surg. Oncol. 2014; 21 (4): 1323-1329. DOI: 10.1245/s10434-013-3449-9.

31. Grut H., Solberg S., Seierstad T., Revheim M.E., Egge T.S., Larsen S.G., Line P.D., Dueland S. Growth rates of pulmonary metastases after liver transplantation for unresectable colorectal liver metastases. Br. J. Surg. 2018; 105 (3): 295-301. DOI: 10.1002/bjs.10651.

32. Furtado A., Tome L., Oliveira FJ., Furtado E., Viana J., Perdigoto R. Sequential liver transplantation. Transplant. Proc. 1997; 29 (1-2): 467-468.

33. NHSBT. Liver Transplantation: Selection Criteria and Recipient Registration, 2018. Available from: https://nhsbtdbe.blob.core. windows.net/umbraco-assets-corp/9440/pol195_7-liver-selection-policy.pdf.

34. Gorgen A., Muaddi H., Zhang W., McGilvray I., Gallinger S., Sapisochin G. The new era of transplant oncology: liver transplantation for nonresectable colorectal cancer liver meta-stases. Can. J. Gastroenterol. Hepatol. 2018; 2018: 9531925. DOI: 10.1155/2018/9531925.

35. Sapisochin G. University Health Network, Toronto. Assessment of a protocol using a combination of neo-adjuvant chemotherapy plus living donor liver transplantation for non-resectable liver metastases from colorectal cancer. Available from: https://clinicaltrials.gov/ct2/show/NCT02864485.

36. Grut H., Dueland S., Line P.D., Revheim M.E. The prognostic value of 18F-FDG PET/CT prior to liver transplantation for nonresectable colorectal liver metastases. Eur. J. Nucl Med. Mol. Imaging. 2018; 45 (2): 218-225. DOI: 10.1007/s00259-017-3843-9.

37. Dueland S., Guren T.K., Hagness M., Glimelius B., Line P.D., Pfeiffer P., Foss A., Tveit K.M. Chemotherapy or liver transplantation for nonresectable liver metastases from colorectal cancer? Ann. Surg. 2015; 261 (5): 956-960. DOI: 10.1097/SLA.0000000000000786.

38. Adam R., Paul Brousse Hospital, Villejuif. Curative potential of liver transplantation in patients with definitively unresectable colorectal liver metastases (CLM) treated by chemotherapy: a prospective multicentric randomized trial. Available from: https://clinicaltrials.gov/ct2/show/NCT02597348.

39. Dueland S., Oslo University Hospital, Oslo. A randomized clinical trial comparing overall survival in selected patients with colorectal carcinoma treated by liver transplantation or chemotherapy. Available from: https://clinicaltrials.gov/ct2/show/NCT03494946.

40. Dueland S., Oslo University Hospital, Oslo. A randomized controlled clinical trial to evaluate the benefit and efficacy of liver transplantation as treatment for selected patients with liver metastases from colorectal carcinoma. Available from: https://clinicaltrials.gov/ct2/show/NCT01479608.

41. Dueland S., Oslo University Hospital, Oslo. A Phase I/II clinical trial to evaluate the benefit and efficacy of liver resection and partial liver segment 2/3 transplantation with delayed total hepatectomy as treatment for selected patients with liver metastases from colorectal carcinoma. Available from: https://clinicaltrials.gov/ct2/show/NCT02215889.

42. Doyle M.B., Maynard E., Lin Y., Vachharajani N., Shenoy S., Anderson C., Earl M., Lowell J.A., Chapman W.C. Outcomes with split liver transplantation are equivalent to those with whole organ transplantation. J. Am. Coll. Surg. 2013; 217 (1): 102-112. DOI: 10.1016/j.jamcollsurg.2013.03.003.

43. Line P.D., Hagness M., Berstad A.E., Foss A., Dueland S. A novel concept for partial liver transplantation in nonresectable colorectal liver metastases: the RAPID concept. Ann. Surg. 2015; 262 (1): e5-9. DOI: 10.1097/SLA.0000000000001165.

44. Rauchfuss F., Jena University Hospital, Jena, Konigsrainer A. University Hospital Tubingen, Tubingen. Living donor liver transplantation with two stage hepatectomy for patients with isolated, irresectable colorectal liver metastases. Available from: https://clinicaltrials.gov/ct2/show/NCT03488953.