Published online Dec 18, 2025. doi: 10.5500/wjt.v15.i4.104945
Revised: March 3, 2025
Accepted: April 14, 2025
Published online: December 18, 2025
Processing time: 316 Days and 16.9 Hours
Colorectal cancer (CRC) is the third most common cancer globally, with 20%-25% of patients diagnosed at stage IV, significantly affecting overall survival (OS). Only 14% of stage IV patients survive for 5 years with palliative chemotherapy. However, the role of liver transplantation (LT) in the management of CRC liver metastasis (CRCLM) is an evolving area of interest. Recent advancements in oncologic outcomes and clinical understanding have prompted the re-evaluation of LT as a viable treatment option for CRCLM. A promising result from some prospective pilot studies reported a 5-year OS rate of 60% after LT for patients with CRCLM. Key factors influencing eligibility include tumor biology, absence of extrahepatic disease, and the patient's performance status. By synthesizing the latest research findings, we aim to provide a comprehensive overview that sum
Core Tip: It is a well-established fact that more than 40% of patients with colorectal cancer (CRC) develop liver metastasis during the disease course despite all the surveys leading to more suitable systemic treatments, efficient chemotherapy, and surgical resections. liver transplantation (LT) could be a treatment option for patients with unresectable CRC liver metastasis without extrahepatic involvement. The initial assessment and proper selection of suitable patients is mandatory for better outcomes for these patients. It turns out that to be candidates for an LT, patients have to meet strict criteria described in the two prospective studies, SECA-I and SECA-II. Despite the proven benefits of LT for non-resectable colorectal liver metastases, this method is still not widely used worldwide due to a lack of policy and healthcare reforms in many countries.