Portal vein embolisation with application of haematopoietic stem cells in patients with primarily or non-resectable colorectal liver metastases
Language English Country Greece Media print
Document type Journal Article, Research Support, Non-U.S. Gov't
PubMed
25503161
PII: 34/12/7279
Knihovny.cz E-resources
- Keywords
- Colorectal liver metastases, future liver remnant volume, haematopoietic stem cells, portal vein embolisation,
- MeSH
- Hematopoietic Stem Cells MeSH
- Hepatectomy MeSH
- Liver blood supply pathology surgery MeSH
- Colorectal Neoplasms mortality pathology therapy MeSH
- Leukapheresis MeSH
- Middle Aged MeSH
- Humans MeSH
- Liver Neoplasms mortality secondary therapy MeSH
- Disease-Free Survival MeSH
- Liver Regeneration * MeSH
- Aged MeSH
- Embolization, Therapeutic * MeSH
- Hematopoietic Stem Cell Transplantation methods MeSH
- Portal Vein MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
BACKGROUND: Insufficient future liver remnant volume (FLRV) is the main cause of low resectability of liver metastases from colorectal cancer (CLMs). One option for enhancing FLVR growth is the use of portal vein embolisation (PVE) with the application of autologous haematopoietic stem cells (HSCs). PATIENTS AND METHODS: PVE with the application of HSCs was used in 11 patients (group 1) with primarily non-resectable CLMs due to insufficient FLRV without signs of extrahepatic metastases. The control group (group 2) consisted of 14 patients in whom only PVE was performed. We evaluated the product quality, FLRV growth, CLM volume, median survival and progression-free survival (PFS). RESULTS: Product quality was achieved in all collections. In all group-I patients, sufficient FLRV growth occurred within three weeks. In the first and second weeks, FLRV increased optimally in most patients (p<0.006). In 13 out of the 14 group-2 patients, optimum FLVR growth was observed within three weeks following PVE (p<0.002). More rapid FLVR growth was observed in group 1 patients (p<0.01). CLM volume was significantly increased in both the group-2 (p<0.0005) and group-1 (p<0.008) patients at the time of liver resection. There was no significant difference in the growth of the CLM volume between the groups (p<0.18). The median survival was 7.3 and 6.8 months for group 1 and 2 patients, respectively, and the two-year PFS was 28% and 22% (p<0.18), respectively. CONCLUSION: PVE with HSC application is a promising method for effectively stimulating FLRV growth in patients with primarily non-resectable CLMs.
Department of Hematooncology University Hospital Faculty of Medicine in Pilsen Pilsen Czech Republic
Department of Surgery University Hospital Faculty of Medicine in Pilsen Pilsen Czech Republic
Laboratory of Immunoanalysis University Hospital Faculty of Medicine in Pilsen Pilsen Czech Republic
Radiodiagnostic Clinic University Hospital Faculty of Medicine in Pilsen Pilsen Czech Republic