We really enjoyed reading the comments from Dr Mayo and the group from Johns Hopkins but wanted to add other remarks. Unfortunately, as they noted, working with the United Network of Organ Sharing database has its limitations. We considered performing a multivariate analysis of prognostic factors using a Cox proportional hazards model. However, owing to the lack of significant factors in the United Network of Organ Sharing data set, including variables related to tumor behavior (such as tumor size, location, percentage of liver involvement, cell differentiation, treatment of primary tumor, and pretransplantation and posttransplantation treatments), we thought that an analysis of prognostic factors for survival could have been misleading if we only controlled for age, sex, and other less significant variables.
Gedaly R, Daily MF, Davenport DL, McHugh PP, Angulo P, Hundley JC. Neuroendocrine Liver Metastasis: Transplant as Part of Multimodality Liver-Directed Therapy—Reply. Arch Surg. 2012;147(1):99. doi:10.1001/archsurg.147.1.99