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Portal Vein Embolization: Impact of Chemotherapy and Genetic Mutations

We characterized the effect of systemic therapy given after portal vein embolization (PVE) and before hepatectomy on hepatic tumor and functional liver remnant (FLR) volumes. All 76 patients who underwent right PVE from 2002–2016 were retrospectively studied. Etiologies included colorectal cancer (n...

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Autores principales: Deipolyi, Amy R., Zhang, Yu Shrike, Khademhosseini, Ali, Naidu, Sailendra, Borad, Mitesh, Sahin, Burcu, Mathur, Amit K., Oklu, Rahmi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5372995/
https://www.ncbi.nlm.nih.gov/pubmed/28257031
http://dx.doi.org/10.3390/jcm6030026
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author Deipolyi, Amy R.
Zhang, Yu Shrike
Khademhosseini, Ali
Naidu, Sailendra
Borad, Mitesh
Sahin, Burcu
Mathur, Amit K.
Oklu, Rahmi
author_facet Deipolyi, Amy R.
Zhang, Yu Shrike
Khademhosseini, Ali
Naidu, Sailendra
Borad, Mitesh
Sahin, Burcu
Mathur, Amit K.
Oklu, Rahmi
author_sort Deipolyi, Amy R.
collection PubMed
description We characterized the effect of systemic therapy given after portal vein embolization (PVE) and before hepatectomy on hepatic tumor and functional liver remnant (FLR) volumes. All 76 patients who underwent right PVE from 2002–2016 were retrospectively studied. Etiologies included colorectal cancer (n = 44), hepatocellular carcinoma (n = 17), cholangiocarcinoma (n = 10), and other metastases (n = 5). Imaging before and after PVE was assessed. Chart review revealed systemic therapy administration, SNaPshot genetic profiling, and comorbidities. Nine patients received systemic therapy; 67 did not. Tumor volume increased 28% in patients who did not receive and decreased −24% in patients who did receive systemic therapy (p = 0.026), with no difference in FLR growth (28% vs. 34%; p = 0.645). Among 30 patients with genetic profiling, 15 were wild type and 15 had mutations. Mutations were an independent predictor of tumor growth (p = 0.049), but did not impact FLR growth (32% vs. 28%; p = 0.93). Neither cirrhosis, hepatic steatosis, nor diabetes impacted changes in tumor or FLR volume (p > 0.20). Systemic therapy administered after PVE before hepatic lobectomy had no effect on FLR growth; however, it was associated with decreasing tumor volumes. Continuing systemic therapy until hepatectomy may be warranted, particularly in patients with genetic mutations.
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spelling pubmed-53729952017-04-05 Portal Vein Embolization: Impact of Chemotherapy and Genetic Mutations Deipolyi, Amy R. Zhang, Yu Shrike Khademhosseini, Ali Naidu, Sailendra Borad, Mitesh Sahin, Burcu Mathur, Amit K. Oklu, Rahmi J Clin Med Article We characterized the effect of systemic therapy given after portal vein embolization (PVE) and before hepatectomy on hepatic tumor and functional liver remnant (FLR) volumes. All 76 patients who underwent right PVE from 2002–2016 were retrospectively studied. Etiologies included colorectal cancer (n = 44), hepatocellular carcinoma (n = 17), cholangiocarcinoma (n = 10), and other metastases (n = 5). Imaging before and after PVE was assessed. Chart review revealed systemic therapy administration, SNaPshot genetic profiling, and comorbidities. Nine patients received systemic therapy; 67 did not. Tumor volume increased 28% in patients who did not receive and decreased −24% in patients who did receive systemic therapy (p = 0.026), with no difference in FLR growth (28% vs. 34%; p = 0.645). Among 30 patients with genetic profiling, 15 were wild type and 15 had mutations. Mutations were an independent predictor of tumor growth (p = 0.049), but did not impact FLR growth (32% vs. 28%; p = 0.93). Neither cirrhosis, hepatic steatosis, nor diabetes impacted changes in tumor or FLR volume (p > 0.20). Systemic therapy administered after PVE before hepatic lobectomy had no effect on FLR growth; however, it was associated with decreasing tumor volumes. Continuing systemic therapy until hepatectomy may be warranted, particularly in patients with genetic mutations. MDPI 2017-03-01 /pmc/articles/PMC5372995/ /pubmed/28257031 http://dx.doi.org/10.3390/jcm6030026 Text en © 2017 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Deipolyi, Amy R.
Zhang, Yu Shrike
Khademhosseini, Ali
Naidu, Sailendra
Borad, Mitesh
Sahin, Burcu
Mathur, Amit K.
Oklu, Rahmi
Portal Vein Embolization: Impact of Chemotherapy and Genetic Mutations
title Portal Vein Embolization: Impact of Chemotherapy and Genetic Mutations
title_full Portal Vein Embolization: Impact of Chemotherapy and Genetic Mutations
title_fullStr Portal Vein Embolization: Impact of Chemotherapy and Genetic Mutations
title_full_unstemmed Portal Vein Embolization: Impact of Chemotherapy and Genetic Mutations
title_short Portal Vein Embolization: Impact of Chemotherapy and Genetic Mutations
title_sort portal vein embolization: impact of chemotherapy and genetic mutations
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5372995/
https://www.ncbi.nlm.nih.gov/pubmed/28257031
http://dx.doi.org/10.3390/jcm6030026
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