Advanced

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 LU ; Larsen, Peter Nørgaard; Larsson, Anna Lindhoff; Schultz, Nicolai A.; Björnbeth, Bjorn Atle and Isaksson, Bengt, et al. (2018) In Journal of Gastrointestinal Surgery
Abstract

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... (More)

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.

(Less)
Please use this url to cite or link to this publication:
author
, et al. (More)
(Less)
publishing date
type
Contribution to journal
publication status
epub
subject
keywords
Colorectal liver metastases, Future liver remnant, Liver surgery, Portal vein embolization, Portal vein ligation
in
Journal of Gastrointestinal Surgery
publisher
Springer
external identifiers
  • scopus:85057097707
ISSN
1091-255X
DOI
10.1007/s11605-018-4031-3
language
English
LU publication?
no
id
47fc3e23-0880-4992-b5cd-b7a564405f2f
date added to LUP
2018-12-05 12:26:14
date last changed
2019-01-06 14:18:37
@article{47fc3e23-0880-4992-b5cd-b7a564405f2f,
  abstract     = {<p>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) &lt; 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 &lt; 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.</p>},
  author       = {Hasselgren, Kristina and Sandström, Per and Røsok, Bård Ingvald and Sparrelid, Ernesto and Lindell, Gert and Larsen, Peter Nørgaard and Larsson, Anna Lindhoff and Schultz, Nicolai A. and Björnbeth, Bjorn Atle and Isaksson, Bengt and Rizell, Magnus and Björnsson, Bergthor},
  issn         = {1091-255X},
  keyword      = {Colorectal liver metastases,Future liver remnant,Liver surgery,Portal vein embolization,Portal vein ligation},
  language     = {eng},
  month        = {11},
  publisher    = {Springer},
  series       = {Journal of Gastrointestinal Surgery},
  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},
  url          = {http://dx.doi.org/10.1007/s11605-018-4031-3},
  year         = {2018},
}