Liver transplantation for nonresectable liver metastases from colorectal cancer was abandoned in 1994 on account of high recurrence rates.
Dr Sonja Kappel and colleagues assessed genetic detection of micrometastases in histologically negative lymph nodes of primary colon cancer.
The research team evaluated whether this could be applied to select patients for liver transplantation.
The team analyzed 21 patients with colorectal cancer who had undergone liver transplantation between 1983 and 1994 for liver metastases.
Of these, 11 patients were histologically lymph node negative at the time of surgery.
There were 10 patients with lymph node metastases that served as a control group.
|p53 was detected in 12 of the 21 patients|
DNA sequencing was used to screen tumor material for p53 and K-ras mutations.
Mutant allele-specific amplification was then used to search for micrometastases in DNA from regional lymph nodes of the primary colorectal cancer.
The researchers detected p53 in 12 of the patients, and K-ras mutations in 3 of the 21 patients in the colorectal cancer group.
The mutations were confirmed in the corresponding liver metastases.
Of 11 patients with histologically negative lymph nodes, 9 were eligible for Mutant allele-specific amplification due to presence of p53 or K-ras mutation.
The team used mutant allele-specific amplification to show that 6 of 9 patients were genetically positive for micrometastases.
The researchers observed that 3 patients were both genetically and histologically negative.
These 3 patients showed a significantly longer overall survival of 4, 5, and 20 years, respectively.
Dr Kappel's team concludes, “The genetic detection of micrometastases by Mutant allele-specific amplification could be a powerful prognostic indicator for selecting patients with colorectal liver metastases who could benefit from liver transplantation.”