Cargando…
Segment 2/3 Hypertrophy is Greater When Right Portal Vein Embolisation is Extended to Segment 4 in Patients with Colorectal Liver Metastases: A Retrospective Cohort Study
BACKGROUND: In patients with colorectal cancer liver metastases (CRLM), right portal vein embolisation (RPVE) is used to increase the volume of the future remnant liver (FRL) before major hepatic resection. It is not established whether embolisation of segment 4 in addition RPVE (RPVE + 4) induces g...
Autores principales: | , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer US
2019
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6394476/ https://www.ncbi.nlm.nih.gov/pubmed/30656390 http://dx.doi.org/10.1007/s00270-018-02159-5 |
_version_ | 1783398903207428096 |
---|---|
author | Hammond, Christopher J. Ali, Saadat Haq, Hafizul Luo, Lorna Wyatt, Judith I. Toogood, Giles J. Lodge, J. Peter A. Patel, Jai V. |
author_facet | Hammond, Christopher J. Ali, Saadat Haq, Hafizul Luo, Lorna Wyatt, Judith I. Toogood, Giles J. Lodge, J. Peter A. Patel, Jai V. |
author_sort | Hammond, Christopher J. |
collection | PubMed |
description | BACKGROUND: In patients with colorectal cancer liver metastases (CRLM), right portal vein embolisation (RPVE) is used to increase the volume of the future remnant liver (FRL) before major hepatic resection. It is not established whether embolisation of segment 4 in addition RPVE (RPVE + 4) induces greater hypertrophy of the FRL. Limitations of prior studies include heterogenous populations and use of hypertrophy metrics sensitive to baseline variables. METHODS: From 2010 to 2015, consecutive patients undergoing RPVE or RPVE + 4 for CRLM, who had not undergone prior major hepatic resection and in whom imaging was available, were included in a retrospective study. Data were extracted from hospital electronic records. Volumetric assessments of segments 2–3 were made on cross-sectional imaging before and after embolisation and corrected for standardised liver volume. RESULTS: Ninety-nine patients underwent PVE, and 60 met the inclusion criteria. Thirty-eight patients underwent RPVE, and 22 underwent RPVE + 4. Forty-five patients had undergone median 6 cycles of prior chemotherapy. Eighteen patients had FRL metastases at PVE, and 16 had undergone subsegmental metastasectomy in the FRL. Assessments of the degree of hypertrophy (DH) of segments 2/3 were made at median 35 (interquartile range 30–49) days after PVE. RPVE + 4 resulted in a significantly greater increase in DH than RPVE (7.7 ± 1.8% vs 11.3 ± 2.6%, p = 0.011). No confounding association between baseline variables and the decision to undertake RPVE or RPVE + 4 was identified. Median survival was 2.4 years and was not influenced by segment 4 embolisation. CONCLUSION: RPVE + 4 results in greater DH of segments 2/3 than RPVE in people with CLRM. |
format | Online Article Text |
id | pubmed-6394476 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Springer US |
record_format | MEDLINE/PubMed |
spelling | pubmed-63944762019-03-15 Segment 2/3 Hypertrophy is Greater When Right Portal Vein Embolisation is Extended to Segment 4 in Patients with Colorectal Liver Metastases: A Retrospective Cohort Study Hammond, Christopher J. Ali, Saadat Haq, Hafizul Luo, Lorna Wyatt, Judith I. Toogood, Giles J. Lodge, J. Peter A. Patel, Jai V. Cardiovasc Intervent Radiol Clinical Investigation BACKGROUND: In patients with colorectal cancer liver metastases (CRLM), right portal vein embolisation (RPVE) is used to increase the volume of the future remnant liver (FRL) before major hepatic resection. It is not established whether embolisation of segment 4 in addition RPVE (RPVE + 4) induces greater hypertrophy of the FRL. Limitations of prior studies include heterogenous populations and use of hypertrophy metrics sensitive to baseline variables. METHODS: From 2010 to 2015, consecutive patients undergoing RPVE or RPVE + 4 for CRLM, who had not undergone prior major hepatic resection and in whom imaging was available, were included in a retrospective study. Data were extracted from hospital electronic records. Volumetric assessments of segments 2–3 were made on cross-sectional imaging before and after embolisation and corrected for standardised liver volume. RESULTS: Ninety-nine patients underwent PVE, and 60 met the inclusion criteria. Thirty-eight patients underwent RPVE, and 22 underwent RPVE + 4. Forty-five patients had undergone median 6 cycles of prior chemotherapy. Eighteen patients had FRL metastases at PVE, and 16 had undergone subsegmental metastasectomy in the FRL. Assessments of the degree of hypertrophy (DH) of segments 2/3 were made at median 35 (interquartile range 30–49) days after PVE. RPVE + 4 resulted in a significantly greater increase in DH than RPVE (7.7 ± 1.8% vs 11.3 ± 2.6%, p = 0.011). No confounding association between baseline variables and the decision to undertake RPVE or RPVE + 4 was identified. Median survival was 2.4 years and was not influenced by segment 4 embolisation. CONCLUSION: RPVE + 4 results in greater DH of segments 2/3 than RPVE in people with CLRM. Springer US 2019-01-17 2019 /pmc/articles/PMC6394476/ /pubmed/30656390 http://dx.doi.org/10.1007/s00270-018-02159-5 Text en © The Author(s) 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. |
spellingShingle | Clinical Investigation Hammond, Christopher J. Ali, Saadat Haq, Hafizul Luo, Lorna Wyatt, Judith I. Toogood, Giles J. Lodge, J. Peter A. Patel, Jai V. Segment 2/3 Hypertrophy is Greater When Right Portal Vein Embolisation is Extended to Segment 4 in Patients with Colorectal Liver Metastases: A Retrospective Cohort Study |
title | Segment 2/3 Hypertrophy is Greater When Right Portal Vein Embolisation is Extended to Segment 4 in Patients with Colorectal Liver Metastases: A Retrospective Cohort Study |
title_full | Segment 2/3 Hypertrophy is Greater When Right Portal Vein Embolisation is Extended to Segment 4 in Patients with Colorectal Liver Metastases: A Retrospective Cohort Study |
title_fullStr | Segment 2/3 Hypertrophy is Greater When Right Portal Vein Embolisation is Extended to Segment 4 in Patients with Colorectal Liver Metastases: A Retrospective Cohort Study |
title_full_unstemmed | Segment 2/3 Hypertrophy is Greater When Right Portal Vein Embolisation is Extended to Segment 4 in Patients with Colorectal Liver Metastases: A Retrospective Cohort Study |
title_short | Segment 2/3 Hypertrophy is Greater When Right Portal Vein Embolisation is Extended to Segment 4 in Patients with Colorectal Liver Metastases: A Retrospective Cohort Study |
title_sort | segment 2/3 hypertrophy is greater when right portal vein embolisation is extended to segment 4 in patients with colorectal liver metastases: a retrospective cohort study |
topic | Clinical Investigation |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6394476/ https://www.ncbi.nlm.nih.gov/pubmed/30656390 http://dx.doi.org/10.1007/s00270-018-02159-5 |
work_keys_str_mv | AT hammondchristopherj segment23hypertrophyisgreaterwhenrightportalveinembolisationisextendedtosegment4inpatientswithcolorectallivermetastasesaretrospectivecohortstudy AT alisaadat segment23hypertrophyisgreaterwhenrightportalveinembolisationisextendedtosegment4inpatientswithcolorectallivermetastasesaretrospectivecohortstudy AT haqhafizul segment23hypertrophyisgreaterwhenrightportalveinembolisationisextendedtosegment4inpatientswithcolorectallivermetastasesaretrospectivecohortstudy AT luolorna segment23hypertrophyisgreaterwhenrightportalveinembolisationisextendedtosegment4inpatientswithcolorectallivermetastasesaretrospectivecohortstudy AT wyattjudithi segment23hypertrophyisgreaterwhenrightportalveinembolisationisextendedtosegment4inpatientswithcolorectallivermetastasesaretrospectivecohortstudy AT toogoodgilesj segment23hypertrophyisgreaterwhenrightportalveinembolisationisextendedtosegment4inpatientswithcolorectallivermetastasesaretrospectivecohortstudy AT lodgejpetera segment23hypertrophyisgreaterwhenrightportalveinembolisationisextendedtosegment4inpatientswithcolorectallivermetastasesaretrospectivecohortstudy AT pateljaiv segment23hypertrophyisgreaterwhenrightportalveinembolisationisextendedtosegment4inpatientswithcolorectallivermetastasesaretrospectivecohortstudy |