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

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Journal of Gastrointestinal Surgery Aims and scope

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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Authors and Affiliations

  1. Department of Surgery, Teikyo University Chiba Medical Center, 3426-3 Anesaki, Ichihara, Chiba, 299-0111, Japan

    Yutaro Kikuchi, Yukihiko Hiroshima, Kenichi Matsuo, Takashi Murakami, Daisuke Kawaguchi & Kuniya Tanaka

  2. Departments of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan

    Itaru Endo

  3. Division of Diagnostic Pathology, Teikyo University Chiba Medical Center, Chiba, Japan

    Kazuto Yamazaki & Yasuo Ishida

Authors
  1. Yutaro Kikuchi
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  2. Yukihiko Hiroshima
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  3. Kenichi Matsuo
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  4. Takashi Murakami
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  5. Daisuke Kawaguchi
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  6. Itaru Endo
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  7. Kazuto Yamazaki
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  8. Yasuo Ishida
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  9. Kuniya Tanaka
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Contributions

Yutaro Kikuchi: meet all 4 criteria of guidelines of ICMJE, Yukihiko Hiroshima; meet all 4 criteria of guidelines of ICMJE, Kenichi Matsuo; meet all 4 criteria of guidelines of ICMJE, Takashi Murakami; meet all 4 criteria of guidelines of ICMJE, Daisuke Kawaguchi; meet all 4 criteria of guidelines of ICMJE, Kazuto Yamazaki; meet all 4 criteria of guidelines of ICMJE, Yasuo Ishida; meet all 4 criteria of guidelines of ICMJE, Itaru Endo; meet all 4 criteria of guidelines of ICMJE, Kuniya Tanaka; meet all 4 criteria of guidelines of ICMJE.

Corresponding author

Correspondence to Kuniya Tanaka.

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There were no grant support about our study.

Conflict of Interest

The authors declare that they have no conflict of interest.

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Kikuchi, Y., Hiroshima, Y., Matsuo, K. et al. Remnant Liver Tumor Growth Activity During Treatment Associating Liver Partition and Portal Vein Occlusion for Staged Hepatectomy (ALPPS). J Gastrointest Surg 21, 1851–1858 (2017). https://doi.org/10.1007/s11605-017-3523-x

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  • DOI: https://doi.org/10.1007/s11605-017-3523-x

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