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Future Liver Remnant (FLR) Increase in Patients with Colorectal Liver Metastases Is Highest the First Week After Portal Vein Occlusion: FLR Increase in Patients with CRLM Is Highest the First Week After PVO

BACKGROUND: Portal vein occlusion (PVO) is an established method to increase the volume of the future liver remnant (FLR). The main reasons for not proceeding to radical hepatectomy are lack of volume increase and tumor progression due to a wait-time interval of up to 8 weeks. The hypothesis was tha...

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Autores principales: Hasselgren, Kristina, Sandström, Per, Røsok, Bård Ingvald, Sparrelid, Ernesto, Lindell, Gert, Larsen, Peter Nørgaard, Larsson, Anna Lindhoff, Schultz, Nicolai A., Björnbeth, Bjorn Atle, Isaksson, Bengt, Rizell, Magnus, Björnsson, Bergthor
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer US 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6414468/
https://www.ncbi.nlm.nih.gov/pubmed/30465187
http://dx.doi.org/10.1007/s11605-018-4031-3
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author Hasselgren, Kristina
Sandström, Per
Røsok, Bård Ingvald
Sparrelid, Ernesto
Lindell, Gert
Larsen, Peter Nørgaard
Larsson, Anna Lindhoff
Schultz, Nicolai A.
Björnbeth, Bjorn Atle
Isaksson, Bengt
Rizell, Magnus
Björnsson, Bergthor
author_facet Hasselgren, Kristina
Sandström, Per
Røsok, Bård Ingvald
Sparrelid, Ernesto
Lindell, Gert
Larsen, Peter Nørgaard
Larsson, Anna Lindhoff
Schultz, Nicolai A.
Björnbeth, Bjorn Atle
Isaksson, Bengt
Rizell, Magnus
Björnsson, Bergthor
author_sort Hasselgren, Kristina
collection PubMed
description BACKGROUND: Portal vein occlusion (PVO) is an established method to increase the volume of the future liver remnant (FLR). The main reasons for not proceeding to radical hepatectomy are lack of volume increase and tumor progression due to a wait-time interval of up to 8 weeks. The hypothesis was that the increase in FLR volume is not linear and is largest during the first weeks. METHODS: Patients with colorectal liver metastases (CRLM) and standardized future liver remnant (sFLR) < 30% treated with PVO were prospectively included. All patients had at least one CT evaluation before radical hepatectomy. RESULTS: Forty-eight patients were included. During the first week after PVO, the kinetic growth rate (KGR) was 5.4 (± 4), compared to 1.5 (± 2) between the first and second CT (p < 0.05). For patients reaching adequate FLR and therefore treated with radical hepatectomy, the KGR was 7 (± 4) the first week, compared to 4.3 (± 2) for patients who failed to reach a sufficient volume (p = 0.4). During the interval between the first and second CT, the KGR was 2.2 (± 2), respectively (± 0.1) (p = 0.017). DISCUSSION: The increase in liver volume after PVO is largest during the first week. As KGR decreases over time, it is important to shorten the interval between PVO and the first volume evaluation; this may aid in decision-making and reduce unnecessary waiting time.
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spelling pubmed-64144682019-04-03 Future Liver Remnant (FLR) Increase in Patients with Colorectal Liver Metastases Is Highest the First Week After Portal Vein Occlusion: FLR Increase in Patients with CRLM Is Highest the First Week After PVO Hasselgren, Kristina Sandström, Per Røsok, Bård Ingvald Sparrelid, Ernesto Lindell, Gert Larsen, Peter Nørgaard Larsson, Anna Lindhoff Schultz, Nicolai A. Björnbeth, Bjorn Atle Isaksson, Bengt Rizell, Magnus Björnsson, Bergthor J Gastrointest Surg Original Article BACKGROUND: Portal vein occlusion (PVO) is an established method to increase the volume of the future liver remnant (FLR). The main reasons for not proceeding to radical hepatectomy are lack of volume increase and tumor progression due to a wait-time interval of up to 8 weeks. The hypothesis was that the increase in FLR volume is not linear and is largest during the first weeks. METHODS: Patients with colorectal liver metastases (CRLM) and standardized future liver remnant (sFLR) < 30% treated with PVO were prospectively included. All patients had at least one CT evaluation before radical hepatectomy. RESULTS: Forty-eight patients were included. During the first week after PVO, the kinetic growth rate (KGR) was 5.4 (± 4), compared to 1.5 (± 2) between the first and second CT (p < 0.05). For patients reaching adequate FLR and therefore treated with radical hepatectomy, the KGR was 7 (± 4) the first week, compared to 4.3 (± 2) for patients who failed to reach a sufficient volume (p = 0.4). During the interval between the first and second CT, the KGR was 2.2 (± 2), respectively (± 0.1) (p = 0.017). DISCUSSION: The increase in liver volume after PVO is largest during the first week. As KGR decreases over time, it is important to shorten the interval between PVO and the first volume evaluation; this may aid in decision-making and reduce unnecessary waiting time. Springer US 2018-11-21 2019 /pmc/articles/PMC6414468/ /pubmed/30465187 http://dx.doi.org/10.1007/s11605-018-4031-3 Text en © The Author(s) 2018 Open Access This 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 Original Article
Hasselgren, Kristina
Sandström, Per
Røsok, Bård Ingvald
Sparrelid, Ernesto
Lindell, Gert
Larsen, Peter Nørgaard
Larsson, Anna Lindhoff
Schultz, Nicolai A.
Björnbeth, Bjorn Atle
Isaksson, Bengt
Rizell, Magnus
Björnsson, Bergthor
Future Liver Remnant (FLR) Increase in Patients with Colorectal Liver Metastases Is Highest the First Week After Portal Vein Occlusion: FLR Increase in Patients with CRLM Is Highest the First Week After PVO
title Future Liver Remnant (FLR) Increase in Patients with Colorectal Liver Metastases Is Highest the First Week After Portal Vein Occlusion: FLR Increase in Patients with CRLM Is Highest the First Week After PVO
title_full Future Liver Remnant (FLR) Increase in Patients with Colorectal Liver Metastases Is Highest the First Week After Portal Vein Occlusion: FLR Increase in Patients with CRLM Is Highest the First Week After PVO
title_fullStr Future Liver Remnant (FLR) Increase in Patients with Colorectal Liver Metastases Is Highest the First Week After Portal Vein Occlusion: FLR Increase in Patients with CRLM Is Highest the First Week After PVO
title_full_unstemmed Future Liver Remnant (FLR) Increase in Patients with Colorectal Liver Metastases Is Highest the First Week After Portal Vein Occlusion: FLR Increase in Patients with CRLM Is Highest the First Week After PVO
title_short Future Liver Remnant (FLR) Increase in Patients with Colorectal Liver Metastases Is Highest the First Week After Portal Vein Occlusion: FLR Increase in Patients with CRLM Is Highest the First Week After PVO
title_sort future liver remnant (flr) increase in patients with colorectal liver metastases is highest the first week after portal vein occlusion: flr increase in patients with crlm is highest the first week after pvo
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6414468/
https://www.ncbi.nlm.nih.gov/pubmed/30465187
http://dx.doi.org/10.1007/s11605-018-4031-3
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