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01-11-2017 | Original Article

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

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

Published in: Journal of Gastrointestinal Surgery | Issue 11/2017

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.

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Title: Remnant Liver Tumor Growth Activity During Treatment Associating Liver Partition and Portal Vein Occlusion for Staged Hepatectomy (ALPPS)
Authors: Yutaro Kikuchi
Yukihiko Hiroshima
Kenichi Matsuo
Takashi Murakami
Daisuke Kawaguchi
Itaru Endo
Kazuto Yamazaki
Yasuo Ishida
Kuniya Tanaka
Publication date: 01-11-2017
Publisher: Springer US
Published in: Journal of Gastrointestinal Surgery / Issue 11/2017
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-017-3523-x

At a glance: The STEP trials

Springer Medicine

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

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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