SALT for Unresectable Colorectal Liver Metastases

Inclusion Criteria:

1. Age 18-75;
2. Physical fitness status (ECOG) 0\~1;
3. Histologically confirmed primary colorectal neoplasm. The time from primary colorectal tumor resection to transplantation is ≥3 months and the stage of primary colorectal tumor is ≤T3N1. Accept T4N0 or T4N2 if primary tumor resection interval is ≥ 2 years
4. Liver metastases (CRLM) located in bilateral livers, or limited to liver and unresectable CRLM after discussion by MDT;
5. According to PET/CT, CT and MRI, there are no other abdominal metastases except the liver or 1-3 resectable lung metastases;
6. Patients have received at least 6-8 weeks of first-line chemotherapy at the time of screening. According to RECIST criteria, CRLM was stable or partially regressed during and after treatment (still not completely resectable);
7. The CEA (carcinoembryonic antigen) value before screening is ≤80 µg/L or the highest level after treatment is reduced by ≥ 50%;
8. Sign the informed consent form.

Exclusion Criteria:

1. Extrahepatic tumor burden (except for resectable lung metastases) and/or large vessel tumor infiltration;
2. The largest liver tumor lesion \>5.5cm at the time of screening;
3. Tumor progression during chemotherapy or severe comorbidities that make transplantation impossible;
4. BRAF mutation and/or microsatellite instability primary tumor (MSI);
5. Suffering from other primary malignant tumors in the past 5 years;
6. Cardiopulmonary disease that cannot be corrected, with high surgical risk, or anatomical abnormality that makes liver transplantation impossible;
7. Substance abuse, medical, psychological or social conditions may interfere with the patient's participation in the study or evaluation of the study results;
8. Combined with AIDS and other diseases that affect surgery or tumor progression;
9. Pregnant or lactating patients;
10. Other reasons that the researchers think are not suitable for participation.