LiT-Met

Colorectal cancer is the third most common malignancy globally, with liver metastases responsible for over half of related deaths. While liver resection offers curative potential, long-term survival in borderline resectable cases remains poor. Liver transplantation (LT), once contraindicated for colorectal liver metastases (CRLM), has recently shown promising outcomes, with 5-year survival rates reaching 83% in selected patients. The LiT-Met project aims to generate robust multicentre evidence demonstrating that LT provides superior survival compared to current surgical standards in borderline resectable CRLM. The ultimate goal is to develop pan-European evidence-based guidelines and adapt national allocation policies to ensure equitable access to life-prolonging therapies. To achieve this, LiT-Met will pursue six specific objectives: improve overall survival through prospective cohort studies and long-term follow-up; develop an AI-based prognostic model integrating clinical, pathological, and molecular data; perform comprehensive molecular profiling of tumors and circulating biomarkers; implement an AI-supported clinical decision system combining imaging and biomarkers; conduct a European-wide cost-effectiveness analysis comparing LT and resection; and integrate patient-reported outcomes and quality-of-life measures into clinical endpoints and policy recommendations. These efforts will culminate in harmonized transplant eligibility criteria, improved patient selection, and enhanced survival and quality of life. By combining clinical, biological, economic, and societal dimensions, LiT-Met will catalyze a paradigm shift in transplant oncology across Europe. This action is part of the Cancer Mission cluster of projects on “Diagnosis and Treatment-Innovative Surgery