TY - JOUR
T1 - Increased kinetic growth rate during late phase liver regeneration impacts the risk of tumor recurrence after colorectal liver metastases resection
AU - Margonis, Georgios A.
AU - Sasaki, Kazunari
AU - Andreatos, Nikolaos
AU - Pour, Manijeh Zargham
AU - Shao, Nannan
AU - Ghasebeh, Mounes Aliyari
AU - Buettner, Stefan
AU - Antoniou, Efstathios
AU - Wolfgang, Christopher L.
AU - Weiss, Matthew
AU - Kamel, Ihab R.
AU - Pawlik, Timothy M.
N1 - Funding Information:
Georgios Antonios Margonis was supported by Bodossaki Foundation.
Publisher Copyright:
© 2017 International Hepato-Pancreato-Biliary Association Inc.
PY - 2017/9
Y1 - 2017/9
N2 - Background Although experimental data strongly support the pro-tumorigenic role of postoperative liver regeneration, this hypothesis has not been clinically investigated. We aimed to examine the impact of liver regeneration determined by volumetric imaging on recurrence following resection of colorectal liver metastasis (CRLM). Methods Resected liver volume was subtracted from total liver volume (TLV) to define postoperative remnant liver volume (RLVp). Early and late kinetic growth rates (KGR) were defined as the postoperative increases in liver volume within 2–3 and 8–10 months from surgery, respectively, divided by the corresponding time interval. Results Median early and late KGR was 2.6%/month (IQR: −0.9 to 12.3) and 1.0%/month (IQR: −0.64 to 2.91), respectively. Late KGR predicted intrahepatic recurrence after 1 year from surgery (AUC 0.677, P = 0.011). Specifically, patients with a late KGR ≥1% had a higher cumulative risk of recurrence compared with patients with a KGR <1% (P = 0.038). In multivariate analysis, KGR ≥1% independently predicted recurrence (P = 0.027). Discussion A KGR ≥1% during the late regeneration phase was associated with increased risk of intrahepatic recurrence. These data may inform the timing of adjuvant therapy administration and focus surveillance strategies for high-risk patients.
AB - Background Although experimental data strongly support the pro-tumorigenic role of postoperative liver regeneration, this hypothesis has not been clinically investigated. We aimed to examine the impact of liver regeneration determined by volumetric imaging on recurrence following resection of colorectal liver metastasis (CRLM). Methods Resected liver volume was subtracted from total liver volume (TLV) to define postoperative remnant liver volume (RLVp). Early and late kinetic growth rates (KGR) were defined as the postoperative increases in liver volume within 2–3 and 8–10 months from surgery, respectively, divided by the corresponding time interval. Results Median early and late KGR was 2.6%/month (IQR: −0.9 to 12.3) and 1.0%/month (IQR: −0.64 to 2.91), respectively. Late KGR predicted intrahepatic recurrence after 1 year from surgery (AUC 0.677, P = 0.011). Specifically, patients with a late KGR ≥1% had a higher cumulative risk of recurrence compared with patients with a KGR <1% (P = 0.038). In multivariate analysis, KGR ≥1% independently predicted recurrence (P = 0.027). Discussion A KGR ≥1% during the late regeneration phase was associated with increased risk of intrahepatic recurrence. These data may inform the timing of adjuvant therapy administration and focus surveillance strategies for high-risk patients.
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U2 - 10.1016/j.hpb.2017.05.002
DO - 10.1016/j.hpb.2017.05.002
M3 - Article
C2 - 28602644
AN - SCOPUS:85020254202
SN - 1365-182X
VL - 19
SP - 808
EP - 817
JO - HPB
JF - HPB
IS - 9
ER -