3 years ago

Remnant Liver Tumor Growth Activity During Treatment Associating Liver Partition and Portal Vein Occlusion for Staged Hepatectomy (ALPPS)

Yasuo Ishida, Kenichi Matsuo, Takashi Murakami, Itaru Endo, Yutaro Kikuchi, Yukihiko Hiroshima, Kuniya Tanaka, Kazuto Yamazaki, Daisuke Kawaguchi

Abstract

Background

We compared tumor growth activity during treatment associating liver partition and portal vein occlusion for staged hepatectomy (ALPPS) with that in classical 2-stage hepatectomy.

Methods

Short-term outcomes, serial changes in volume of the future liver remnant (FLR), and tumor growth activity during the treatment period were compared between 12 patients treated with ALPPS and 20 patients treated with 2-stage hepatectomy for colorectal liver metastases. This study was registered in UMIN Clinical Trials Registry (registration number, UMIN000018622).

Results

The FLR hypertrophy ratio at 1 week after the first operation was greater in the ALPPS group (1.43 ± 0.24) than the 2-stage group (1.21 ± 0.28, P = 0.043). The mean kinetic growth rate (mKGR) of tumors in the ALPPS group (0.548 ± 7.29 mL/day) did not differ significantly from that in the 2-stage group (−3.53 ± 7.02 mL/day) in the first week after the initial procedure (P = 0.210). However, mKGR between 1 and 3 weeks after the first procedure (1.29 ± 2.34 mL/day) was significantly greater than that in first week after the procedure in the 2-stage group (P = 0.034).

Conclusions

ALPPS induces a rapid FLR volume increase while avoiding remnant tumor progression.

Publisher URL: https://link.springer.com/article/10.1007/s11605-017-3523-x

DOI: 10.1007/s11605-017-3523-x

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