Portal vein embolization stimulates tumour growth in patients with colorectal cancer liver metastases
Portal vein embolization (PVE) can facilitate the resection of previously unresectable colorectal cancer (CRC) liver metastases. Bevacizumab is being used increasingly in the treatment of metastatic CRC, although data regarding its effect on post-embolization liver regeneration and tumour growth are...
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Published in | HPB (Oxford, England) Vol. 14; no. 7; pp. 461 - 468 |
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Main Authors | , , , , , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
Oxford, UK
Elsevier Ltd
01.07.2012
Blackwell Publishing Ltd |
Subjects | |
Online Access | Get full text |
ISSN | 1365-182X 1477-2574 1477-2574 |
DOI | 10.1111/j.1477-2574.2012.00476.x |
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Abstract | Portal vein embolization (PVE) can facilitate the resection of previously unresectable colorectal cancer (CRC) liver metastases. Bevacizumab is being used increasingly in the treatment of metastatic CRC, although data regarding its effect on post-embolization liver regeneration and tumour growth are conflicting. The objective of this observational study was to assess the impact of pre-embolization bevacizumab on liver hypertrophy and tumour growth.
Computed tomography scans before and 4weeks after PVE were evaluated in patients who received perioperative chemotherapy with or without bevacizumab. Scans were compared with scans obtained in a control group in which no PVE was administered. Future liver remnant (FLR), total liver volume (TLV) and total tumour volume (TTV) were measured. Bevacizumab was discontinued ≥4weeks before PVE.
A total of 109 patients and 11 control patients were included. Portal vein embolization induced a significant increase in TTV: the right lobe increased by 33.4% in PVE subjects but decreased by 34.8% in control subjects (P < 0.001), and the left lobe increased by 49.9% in PVE subjects and decreased by 33.2% in controls (P= 0.022). A total of 52.8% of the study group received bevacizumab and 47.2% did not. There was no statistical difference between the two chemotherapy groups in terms of tumour growth. Median FLR after PVE was similar in both groups (28.8% vs. 28.7%; P= 0.825).
Adequate liver regeneration was achieved in patients who underwent PVE. However, significant tumour progression was also observed post-embolization. |
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AbstractList | Objectives: Portal vein embolization (PVE) can facilitate the resection of previously unresectable colorectal cancer (CRC) liver metastases. Bevacizumab is being used increasingly in the treatment of metastatic CRC, although data regarding its effect on post‐embolization liver regeneration and tumour growth are conflicting. The objective of this observational study was to assess the impact of pre‐embolization bevacizumab on liver hypertrophy and tumour growth.
Methods: Computed tomography scans before and 4 weeks after PVE were evaluated in patients who received perioperative chemotherapy with or without bevacizumab. Scans were compared with scans obtained in a control group in which no PVE was administered. Future liver remnant (FLR), total liver volume (TLV) and total tumour volume (TTV) were measured. Bevacizumab was discontinued ≥ 4 weeks before PVE.
Results: A total of 109 patients and 11 control patients were included. Portal vein embolization induced a significant increase in TTV: the right lobe increased by 33.4% in PVE subjects but decreased by 34.8% in control subjects (P < 0.001), and the left lobe increased by 49.9% in PVE subjects and decreased by 33.2% in controls (P= 0.022). A total of 52.8% of the study group received bevacizumab and 47.2% did not. There was no statistical difference between the two chemotherapy groups in terms of tumour growth. Median FLR after PVE was similar in both groups (28.8% vs. 28.7%; P= 0.825).
Conclusions: Adequate liver regeneration was achieved in patients who underwent PVE. However, significant tumour progression was also observed post‐embolization. Abstract Objectives Portal vein embolization (PVE) can facilitate the resection of previously unresectable colorectal cancer (CRC) liver metastases. Bevacizumab is being used increasingly in the treatment of metastatic CRC, although data regarding its effect on post-embolization liver regeneration and tumour growth are conflicting. The objective of this observational study was to assess the impact of pre-embolization bevacizumab on liver hypertrophy and tumour growth. Methods Computed tomography scans before and 4 weeks after PVE were evaluated in patients who received perioperative chemotherapy with or without bevacizumab. Scans were compared with scans obtained in a control group in which no PVE was administered. Future liver remnant (FLR), total liver volume (TLV) and total tumour volume (TTV) were measured. Bevacizumab was discontinued ≥ 4 weeks before PVE. Results A total of 109 patients and 11 control patients were included. Portal vein embolization induced a significant increase in TTV: the right lobe increased by 33.4% in PVE subjects but decreased by 34.8% in control subjects ( P < 0.001), and the left lobe increased by 49.9% in PVE subjects and decreased by 33.2% in controls ( P = 0.022). A total of 52.8% of the study group received bevacizumab and 47.2% did not. There was no statistical difference between the two chemotherapy groups in terms of tumour growth. Median FLR after PVE was similar in both groups (28.8% vs. 28.7%; P = 0.825). Conclusions Adequate liver regeneration was achieved in patients who underwent PVE. However, significant tumour progression was also observed post-embolization. Portal vein embolization (PVE) can facilitate the resection of previously unresectable colorectal cancer (CRC) liver metastases. Bevacizumab is being used increasingly in the treatment of metastatic CRC, although data regarding its effect on post-embolization liver regeneration and tumour growth are conflicting. The objective of this observational study was to assess the impact of pre-embolization bevacizumab on liver hypertrophy and tumour growth.OBJECTIVESPortal vein embolization (PVE) can facilitate the resection of previously unresectable colorectal cancer (CRC) liver metastases. Bevacizumab is being used increasingly in the treatment of metastatic CRC, although data regarding its effect on post-embolization liver regeneration and tumour growth are conflicting. The objective of this observational study was to assess the impact of pre-embolization bevacizumab on liver hypertrophy and tumour growth.Computed tomography scans before and 4 weeks after PVE were evaluated in patients who received perioperative chemotherapy with or without bevacizumab. Scans were compared with scans obtained in a control group in which no PVE was administered. Future liver remnant (FLR), total liver volume (TLV) and total tumour volume (TTV) were measured. Bevacizumab was discontinued ≥ 4 weeks before PVE.METHODSComputed tomography scans before and 4 weeks after PVE were evaluated in patients who received perioperative chemotherapy with or without bevacizumab. Scans were compared with scans obtained in a control group in which no PVE was administered. Future liver remnant (FLR), total liver volume (TLV) and total tumour volume (TTV) were measured. Bevacizumab was discontinued ≥ 4 weeks before PVE.A total of 109 patients and 11 control patients were included. Portal vein embolization induced a significant increase in TTV: the right lobe increased by 33.4% in PVE subjects but decreased by 34.8% in control subjects (P < 0.001), and the left lobe increased by 49.9% in PVE subjects and decreased by 33.2% in controls (P= 0.022). A total of 52.8% of the study group received bevacizumab and 47.2% did not. There was no statistical difference between the two chemotherapy groups in terms of tumour growth. Median FLR after PVE was similar in both groups (28.8% vs. 28.7%; P= 0.825).RESULTSA total of 109 patients and 11 control patients were included. Portal vein embolization induced a significant increase in TTV: the right lobe increased by 33.4% in PVE subjects but decreased by 34.8% in control subjects (P < 0.001), and the left lobe increased by 49.9% in PVE subjects and decreased by 33.2% in controls (P= 0.022). A total of 52.8% of the study group received bevacizumab and 47.2% did not. There was no statistical difference between the two chemotherapy groups in terms of tumour growth. Median FLR after PVE was similar in both groups (28.8% vs. 28.7%; P= 0.825).Adequate liver regeneration was achieved in patients who underwent PVE. However, significant tumour progression was also observed post-embolization.CONCLUSIONSAdequate liver regeneration was achieved in patients who underwent PVE. However, significant tumour progression was also observed post-embolization. Portal vein embolization (PVE) can facilitate the resection of previously unresectable colorectal cancer (CRC) liver metastases. Bevacizumab is being used increasingly in the treatment of metastatic CRC, although data regarding its effect on post-embolization liver regeneration and tumour growth are conflicting. The objective of this observational study was to assess the impact of pre-embolization bevacizumab on liver hypertrophy and tumour growth. Computed tomography scans before and 4 weeks after PVE were evaluated in patients who received perioperative chemotherapy with or without bevacizumab. Scans were compared with scans obtained in a control group in which no PVE was administered. Future liver remnant (FLR), total liver volume (TLV) and total tumour volume (TTV) were measured. Bevacizumab was discontinued ≥ 4 weeks before PVE. A total of 109 patients and 11 control patients were included. Portal vein embolization induced a significant increase in TTV: the right lobe increased by 33.4% in PVE subjects but decreased by 34.8% in control subjects (P < 0.001), and the left lobe increased by 49.9% in PVE subjects and decreased by 33.2% in controls (P= 0.022). A total of 52.8% of the study group received bevacizumab and 47.2% did not. There was no statistical difference between the two chemotherapy groups in terms of tumour growth. Median FLR after PVE was similar in both groups (28.8% vs. 28.7%; P= 0.825). Adequate liver regeneration was achieved in patients who underwent PVE. However, significant tumour progression was also observed post-embolization. Portal vein embolization (PVE) can facilitate the resection of previously unresectable colorectal cancer (CRC) liver metastases. Bevacizumab is being used increasingly in the treatment of metastatic CRC, although data regarding its effect on post-embolization liver regeneration and tumour growth are conflicting. The objective of this observational study was to assess the impact of pre-embolization bevacizumab on liver hypertrophy and tumour growth. Computed tomography scans before and 4weeks after PVE were evaluated in patients who received perioperative chemotherapy with or without bevacizumab. Scans were compared with scans obtained in a control group in which no PVE was administered. Future liver remnant (FLR), total liver volume (TLV) and total tumour volume (TTV) were measured. Bevacizumab was discontinued ≥4weeks before PVE. A total of 109 patients and 11 control patients were included. Portal vein embolization induced a significant increase in TTV: the right lobe increased by 33.4% in PVE subjects but decreased by 34.8% in control subjects (P < 0.001), and the left lobe increased by 49.9% in PVE subjects and decreased by 33.2% in controls (P= 0.022). A total of 52.8% of the study group received bevacizumab and 47.2% did not. There was no statistical difference between the two chemotherapy groups in terms of tumour growth. Median FLR after PVE was similar in both groups (28.8% vs. 28.7%; P= 0.825). Adequate liver regeneration was achieved in patients who underwent PVE. However, significant tumour progression was also observed post-embolization. |
Author | Hassanain, Mazen Abualhassan, Nasser Aljiffry, Murad Chaudhury, Prosanto Kavan, Petr Salman, Ayat Al-Abbad, Saleh Simoneau, Eve El Baage, Arwa Cabrera, Tatiana Valenti, David Jamal, Mohammad Metrakos, Peter |
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BackLink | https://www.ncbi.nlm.nih.gov/pubmed/22672548$$D View this record in MEDLINE/PubMed |
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Keywords | bevacizumab colorectal cancer liver metastases liver regeneration tumour growth degree of hypertrophy portal vein embolization |
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References_xml | – volume: 11 start-page: 103 year: 2009 end-page: 107 ident: bb0085 article-title: Hypertrophy of the non-embolized liver after chemotherapy publication-title: HPB – volume: 34 start-page: 267 year: 2001 end-page: 272 ident: bb0100 article-title: Proliferative activity of intrahepatic colorectal metastases after preoperative hemihepatic portal vein embolization publication-title: Hepatology – volume: 60 start-page: 277 year: 2010 end-page: 300 ident: bb0010 article-title: Cancer statistics 2010 publication-title: CA Cancer J Clin – volume: 14 start-page: 359 year: 2010 end-page: 368 ident: bb0095 article-title: Influence of chemotherapy on liver regeneration induced by portal vein embolization or first hepatectomy of a staged procedure for colorectal liver metastases publication-title: J Gastrointest Surg – volume: 21 start-page: 1152 year: 2010 end-page: 1162 ident: bb0060 article-title: Bevacizumab combined with chemotherapy for patients with advanced colorectal cancer: a systematic review publication-title: Ann Oncol – volume: 12 start-page: 37 year: 2010 end-page: 42 ident: bb0145 article-title: Perioperative chemotherapy with bevacizumab and liver resection for colorectal cancer liver metastasis publication-title: HPB – volume: 34 start-page: 1287 year: 2010 end-page: 1294 ident: bb0185 article-title: Tumour thickness at the tumour–normal interface: a novel pathologic indicator of chemotherapy response in hepatic colorectal metastases publication-title: Am J Surg Pathol – volume: 18 start-page: 299 year: 2007 end-page: 304 ident: bb0180 article-title: Importance of histological tumour response assessment in predicting the outcome in patients with colorectal liver metastases treated with neoadjuvant chemotherapy followed by liver surgery publication-title: Ann Oncol – volume: 28 start-page: 18 year: 2008 end-page: 22 ident: bb0040 article-title: Systemic therapy for advanced or metastatic colorectal cancer: National Comprehensive Cancer Network guidelines for combining anti-vascular endothelial growth factor and anti-epidermal growth factor receptor monoclonal antibodies with chemotherapy publication-title: Pharmacotherapy – volume: 25 start-page: 436 year: 2008 end-page: 444 ident: bb0130 article-title: Controversies in the use of portal vein embolization publication-title: Dig Surg – volume: 44 start-page: 98 year: 2003 end-page: 102 ident: bb0110 article-title: Preoperative right portal vein embolization in patients with metastatic liver disease. 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(2002) Extended hepatectomy in patients with hepatobiliary malignancies with and without preoperative portal vein embolization. Arch Surg 137:675-680; discussion 680-681. – reference: American Joint Committee on Cancer. (2010) Cancer Staging Manual, 7th edn. Edge SB, Byrd DR, Compton CC, Fritz AG, Greene FL, Trotti A, eds. New York, NY: Springer, p. 143. – reference: van Gulik TM, van den Esschert JW, de Graaf W, van Lienden KP, Busch OR, Heger M et al. (2008) Controversies in the use of portal vein embolization. Dig Surg 25:436-444. – reference: Chaudhury P, Hassanain M, Bouganim N, Salman A, Kavan P, Metrakos P. (2010) Perioperative chemotherapy with bevacizumab and liver resection for colorectal cancer liver metastasis. HPB 12:37-42. – reference: Ribero D, Abdalla EK, Madoff DC, Donadon M, Loyer EM, Vauthey JN. (2007) Portal vein embolization before major hepatectomy and its effect on regeneration, resectability and outcome. 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Snippet | Portal vein embolization (PVE) can facilitate the resection of previously unresectable colorectal cancer (CRC) liver metastases. Bevacizumab is being used... Abstract Objectives Portal vein embolization (PVE) can facilitate the resection of previously unresectable colorectal cancer (CRC) liver metastases.... Objectives: Portal vein embolization (PVE) can facilitate the resection of previously unresectable colorectal cancer (CRC) liver metastases. Bevacizumab is... |
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SubjectTerms | Angiogenesis Inhibitors - administration & dosage Antibodies, Monoclonal, Humanized - administration & dosage Bevacizumab Chemotherapy, Adjuvant Chi-Square Distribution colorectal cancer liver metastases Colorectal Neoplasms - pathology degree of hypertrophy Embolization, Therapeutic - adverse effects Female Gastroenterology and Hepatology Hepatectomy Humans Liver Neoplasms - diagnostic imaging Liver Neoplasms - secondary Liver Neoplasms - therapy liver regeneration Liver Regeneration - drug effects Male Neoadjuvant Therapy Original Portal Vein portal vein embolization Quebec Retrospective Studies Risk Assessment Risk Factors Time Factors Tomography, X-Ray Computed Treatment Outcome Tumor Burden - drug effects tumour growth |
Title | Portal vein embolization stimulates tumour growth in patients with colorectal cancer liver metastases |
URI | https://www.clinicalkey.com/#!/content/1-s2.0-S1365182X15306134 https://www.clinicalkey.es/playcontent/1-s2.0-S1365182X15306134 https://dx.doi.org/10.1111/j.1477-2574.2012.00476.x https://api.istex.fr/ark:/67375/WNG-NWWT1WKL-K/fulltext.pdf https://onlinelibrary.wiley.com/doi/abs/10.1111%2Fj.1477-2574.2012.00476.x https://www.ncbi.nlm.nih.gov/pubmed/22672548 https://www.proquest.com/docview/1019613416 https://pubmed.ncbi.nlm.nih.gov/PMC3384876 |
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