AUTHOR=Mutlukoca Stern Nadide , Dueland Svein , Line Pål-Dag , Syversveen Trygve , Grut Harald 
  
TITLE=Sex-related differences in survival based on [18F]FDG PET/CT metabolic tumor volume after liver transplantation for colorectal liver metastases
  
JOURNAL=Transplant International
  
VOLUME=Volume 39 - 2026
  
YEAR=2026
  
URL=https://www.frontierspartnerships.org/journals/transplant-international/articles/10.3389/ti.2026.16406
  
DOI=10.3389/ti.2026.16406
  
ISSN=1432-2277
  
ABSTRACT=[18F]FDG PET/CT-derived metabolic tumor volume (MTV) is a strong prognostic biomarker in patients undergoing liver transplantation (LT) for non-resectable colorectal liver metastases (nCRLM). This study aimed to evaluate whether MTV-based survival outcomes after LT for nCRLM differ between males and females. Patients who underwent LT for nCRLM between 2006 and 2022 were included (n = 45). Baseline characteristics were compared using the Mann–Whitney U test and Fisher’s exact test. Overall survival (OS), disease-free survival (DFS), and survival after relapse (SAR) were estimated using Kaplan–Meier analysis with the log-rank test. Cox regression analyses including sex, dichotomized MTV, and an interaction term between sex and MTV were performed. Female patients had significantly shorter OS compared with male patients (median 58 vs. 92 months, p = 0.047). Low MTV was associated with significantly longer OS, DFS and SAR in both sexes. Among patients with high MTV, females had significantly shorter OS than males (median 25 vs. 59 months, p < 0.001). Females had more non-pulmonary recurrences than males (p = 0.006) and shorter median SAR than males (17 vs. 46 months, p < 0.001) with high MTV. A significant interaction between sex and MTV was observed, indicating a particularly adverse prognostic impact of high MTV in female patients.