Search

Background: Liver transplantation (LT) for nonresectable colorectal liver metastasis (NRCRLM) has become accepted for select patients meeting strict inclusion criteria. Advancements in patient selection and understanding of cancer biology may expand benefits to patients with colorectal liver metastasis (CRLM). In this meta-analysis, we sought to assess survival outcomes, recurrence patterns, and quality of life (QoL) after LT for CRLM., Methods: PubMed, Embase, and Scopus databases were searched. A random-effect meta-analysis was conducted to obtain pooled overall survival (OS) and disease-free survival (DFS) rates and to compare QoL from baseline. Continuous data were analyzed, and standardized mean differences were reported., Results: Overall, 16 studies (403 patients, 58.8% male sex) were included. The pooled 1-, 3-, and 5-year OS after LT for NRCRLM was 96% (95% CI: 92%-99%), 77% (95% CI: 62%-89%), and 53% (95% CI: 45%-61%), respectively. Moreover, the pooled 1-, 3-, and 5-year DFS was 58% (95% CI: 43%-72%), 33% (95% CI: 9%-61%), and 13% (95% CI: 4%-27%), respectively. Overall, 201 patients (49.8%) experienced recurrence during the follow-up period with the lungs being the most common site (45.8%). There was no significant differences in physical and emotional functioning, fatigue, and pain components of QoL at 6 months after LT compared with baseline (all P > .05)., Conclusion: LT for NRCRLM demonstrated good OS outcomes with no differences in the QoL at 6 months after transplantation. Transplantation may represent a viable treatment option for NRCRLM., (Copyright © 2024 Society for Surgery of the Alimentary Tract. Published by Elsevier Inc. All rights reserved.)

Background/aims: One of the consequences of inflammatory diseases and neoplastic transformation is disregulation in metabolism of collagen and its interaction with cell surface integrin receptors. Although extracellular collagenases initiate the breakdown of tissue collagen the final step of collagen degradation is mediated by prolidase (E.C.3.4.13.9). We investigated whether prolidase activity may reflect disturbances of collagen metabolism in human pancreatitis and pancreatic cancer., Methodology: Ten human samples of advanced chronic pancreatitis and pancreatic cancer and ten samples of normal pancreas were compared in respect to prolidase activity and expression (western immunoblot), collagen content (hydroxyproline determination), collagenolytic activity (zymography) and beta 1 integrin subunit expression (western immunoblot)., Results: In pancreatitis tissue, an increase in collagen content, collagenolytic activity and beta 1 integrin expression were accompanied by significant decrease (about 2-fold) in prolidase activity and marked decrease in its expression, compared to normal pancreas. Pancreatic cancer tissue, compared to normal pancreas showed insignificant increase in collagen content, dramatic increase of collagenolytic activity and undetectable beta 1 integrin expression. These phenomena were accompanied by over 10-fold decrease in prolidase activity and marked decrease in prolidase expression., Conclusions: The results suggest that prolidase activity may reflect the extent of disturbances in tissue collagen metabolism during pancreatic diseases and the level of its activity may serve as a marker of chronic pancreatitis and pancreatic cancer.