Liver Metastasectomy to Obtain Tumor-Infiltrating Lymphocytes: Technical Considerations and Report on Single-Center Experience

Abstract Background Adoptive cell transfer (ACT) of tumor-infiltrating lymphocytes (TIL) is an FDA-approved treatment for metastatic melanoma and continues to be studied in other cancers. As a common site of metastatic disease, the liver is potentially a useful site for TIL procurement, but only if the procedures can be performed with an acceptably low risk of complications. Methods A retrospective analysis was performed on 158 patients who underwent liver resection for TIL procurement between 2000 and 2024. Patients had metastatic melanoma or epithelial cancers. The primary outcomes were 30 days and 90 days morbidity and mortality. Results Liver resection for TIL was performed in 81 patients with melanoma and 77 patients with epithelial cancers. The overall 30 days and 90 days mortality were 1% and 10%, respectively, and no deaths were attributed to surgery. Complication rates (Clavien-Dindo ≥ III) were 5% and 7%, respectively. Viable tumor was confirmed in 100% of resected lesions. Conclusions Liver resection for TIL procurement is feasible and safe in carefully selected patients. Candidate patients should be discussed in a multidisciplinary setting with both medical and surgical expertise reaching a consensus on the optimal site selection to minimize risk and maximize therapeutic success.