Transplant oncology is an emerging concept of cancer treatment with a promising prospective outcome. The applications of oncology, transplant medicine, and surgery are the core of transplant oncology to improve patients’ survival and quality of life. The main concept of transplant oncology is to radically cure cancer by removing the diseased organ and replacing it with a healthy one, aiming to improve the survival outcomes and quality of life of cancer patients. Subsequently, it seeks to expand the treatment options and research for hepatobiliary malignancies, which have seen significantly improved survival outcomes after the implementation of liver transplantation (LT). In the case of colorectal cancer (CRC) in the transplant setting, where the liver is the most common site of metastasis of patients who are considered to have unresectable disease, initial studies have shown improved survival for LT treatment compared to palliative therapy interventions. The indications of LT for hepatobiliary malignancies have been slowly expanded over the years beyond Milan criteria in a stepwise manner. However, the outcome improvements and overall patient survival are limited to the specifics of the setting and systematic intervention options. This review aims to illustrate the representative concepts and history of transplant oncology as an emerging discipline for the management of hepatobiliary malignancies, in addition to other emerging concepts, such as the uses of immunotherapy in a peri-transplant setting as well as the use of circulating tumor DNA (ctDNA) for surveillance post-transplantation.
移植肿瘤学是一种新兴的癌症治疗理念，具有广阔的发展前景。该学科以肿瘤学、移植医学及外科学的应用为核心，旨在提升患者的生存率与生活质量。其核心理念是通过切除病变器官并移植健康器官来根治癌症，从而改善癌症患者的生存结局与生活品质。在此基础上，该领域致力于拓展肝胆恶性肿瘤的治疗选择与研究空间——自肝移植技术应用以来，这类患者的生存结局已获得显著改善。以结直肠癌肝转移为例，对于无法手术切除的肝转移患者，初步研究显示肝移植治疗相较于姑息治疗能有效提升生存率。多年来，肝胆恶性肿瘤的肝移植适应症已逐步突破米兰标准限制缓慢扩展，但疗效提升与患者总体生存率的改善仍受限于具体临床情境及系统性治疗方案的局限性。本综述旨在阐述移植肿瘤学作为肝胆恶性肿瘤新兴治疗学科的代表性理念与发展历程，同时探讨围移植期免疫治疗应用、循环肿瘤DNA移植后监测等新兴研究方向。
Transplant Oncology: An Emerging Discipline of Cancer Treatment
肿瘤(癌症)患者之家