Due to copyright issues, an electronic copy of the thesis must be ordered from the faculty. For the faculty to have time to process the order, the order must be received by the faculty at the latest 2 days before the public defence. Orders received later than 2 days before the defence will not be processed. After the public defence, please address any inquiries regarding the thesis to the candidate.
Trial Lecture – time and place
See Trial Lecture.
Adjudication committee
- First opponent: Professor and Director, Department of Transplant Surgery Jiri Fronek, Institute for Clinical and Experimental Medicine (IKEM), Prague, Czech Republik
- Second opponent: Professor and Consulant Oncologist Karen Lise Garm Spindler, Aarhus University Hospital, Denmark
- Third member and chair of the evaluation committee: Professor Tom Mala, Faculty of Medicine, University of Oslo
Chair of the Defence
Associate Professor Truls Hauge, University of Oslo
Principal Supervisor
Senior consultant Svein Dueland, Oslo University Hospital
Summary
Colorectal cancer patients with inoperable liver metastases have a poor prognosis with an estimated survival of 24-30 months.
Liver transplantation has emerged as a treatment option in recent years, as studies conducted at Oslo University Hospital has shown vastly improved survival in selected patients compared to historical controls receiving chemotherapy, and several studies are now ongoing in Europe and North America.
The aims of the thesis were to investigate the health-related quality of life, recurrence patterns, treatment after recurrence and survival outcomes in patients with colorectal liver metastases treated with liver transplantation across all study protocols at Oslo University Hospital. Data were collected both retrospectively from medical charts and radiology reports as well as prospectively registered data on patients outcomes. Validated patients-reported questionnaires were used for quality of life analysis.
The majority of transplanted patients experienced disease recurrence, most within two years of transplantation. The majority of recurrences were pulmonary metastases eligible for curative intended treatment.
Patients treated with chemotherapy after liver transplantation had more diarrhea and mucositis as compared to before transplantation, but no more bone marrow toxicity. No graft rejections were observed during chemotherapy treatment. The majority of patients had clinical benefit on chemotherapy given post-transplant. Overall, patients maintained a good health related quality of life for up to three years of follow-up after transplantation, despite treatment for recurrence.
Liver transplantation may in the future become an established treatment option for selected patients.
Additional information
Contact the research support staff.