ALPPS (associating liver partition and portal vein ligation for staged hepatectomy) does not affect proliferation, apoptosis, or angiogenesis as compared to standard liver resection for colorectal liver metastases

URN zum Zitieren dieses Dokuments:

urn:nbn:de:bvb:355-epub-355783 Copy

DOI zum Zitieren dieses Dokuments:

10.5283/epub.35578 Copy

Lang, Sven A. ; Joechele, Katharina ; Moser, Christian ; Ruemmele, Petra ; Schmidt, Katharina Maria ; Werner, Jens M. ; Geissler, Edward K. ; Schlitt, Hans J.

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Lizenz: Creative Commons Namensnennung 4.0 International PDF (1MB)

Veröffentlichungsdatum dieses Volltextes: 21 Apr 2017 15:17

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Details

Dokumentenart:	Artikel
Open Access Art:	Gold (mit APC - bezahlt UR)
Höhe Gebühr (aus OpenAPC):	2003.96
Institution der Zahlung:	Regensburg U
Titel eines Journals oder einer Zeitschrift:	World Journal of Surgical Oncology
Verlag:	BMC
Ort der Veröffentlichung:	LONDON
Band:	15
Nummer des Zeitschriftenheftes oder des Kapitels:	57
Seitenbereich:	S. 1-8
Datum:	7 März 2017
Institutionen:	Medizin > Lehrstuhl für Chirurgie
Identifikationsnummer:	Wert Typ 10.1186/s12957-017-1121-8 DOI
Stichwörter / Keywords:	EXTENDED-RIGHT HEPATECTOMIES; TUMOR-GROWTH; 2-STAGE HEPATECTOMY; HEPATIC RESECTION; EMBOLIZATION; SURVIVAL; RESECTABILITY; REMNANT; CANCER; METAANALYSIS; Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS); Colorectal liver metastases (CRLM); Apoptosis; Proliferation; Vascularization
Dewey-Dezimal-Klassifikation:	600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin
Status:	Veröffentlicht
Begutachtet:	Ja, diese Version wurde begutachtet
An der Universität Regensburg entstanden:	Ja
Dokumenten-ID:	35578

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Zusammenfassung

Background: ALPPS (associating liver partition and portal vein ligation for staged hepatectomy) is a novel two-stage strategy to induce rapid hypertrophy of the future liver remnant (FLR) when patients are in danger of postoperative liver failure due to insufficient FLR. However, the effects of ALPPS on colorectal liver metastases (CRLM) are not clear so far. The aim of our study was to determine ...

Zusammenfassung

Background: ALPPS (associating liver partition and portal vein ligation for staged hepatectomy) is a novel two-stage strategy to induce rapid hypertrophy of the future liver remnant (FLR) when patients are in danger of postoperative liver failure due to insufficient FLR. However, the effects of ALPPS on colorectal liver metastases (CRLM) are not clear so far. The aim of our study was to determine whether ALPPS induces proliferation, apoptosis, or vascularization compared to standard (one-stage) liver resection. Methods: Six patients who underwent ALPPS were matched with 12 patients undergoing standard liver resection regarding characteristics of the metastases (size, number), time of appearance (syn-/metachronous), preoperative chemotherapy, primary tumor (localization, TNM stage, grading), and patient variables (gender, age). The largest resected metastasis was used for the analyses. Tissue was stained for tumor cell proliferation (Ki67), apoptosis (TUNEL, caspase-3), vascularization (CD31), and pericytes (alpha SMA). Results: Vascularization (CD31; p = 0.149), proliferation (Mib-1; p = 0.244), and aSMA expression (p = 0.205) did not significantly differ between the two groups, although a trend towards less proliferation and aSMA expression was observed in patients undergoing ALPPS. Concerning apoptosis, caspase-3 staining showed significantly fewer apoptotic cells upon ALPPS (p < 0.0001), but this was not confirmed by TUNEL staining (p = 0.7344). Conclusions: ALPPS does not induce proliferation, apoptosis, or vascularization of CRLM when compared to standard liver resection.

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