AI Article Synopsis
- Portal vein embolization (PVE) can allow the removal of liver metastases from colorectal cancer, but the role of pre-embolization bevacizumab on liver regeneration and tumor growth is unclear.
- A study evaluated CT scans of 109 patients before and after PVE, comparing results from those treated with bevacizumab and those without, alongside a control group without PVE.
- The findings showed that while PVE led to significant increases in liver volume, there was no notable difference in tumor growth between the chemotherapy groups, indicating that although liver regeneration occurred post-PVE, tumor progression was a concern.
Article 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.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3384876 | PMC |
| http://dx.doi.org/10.1111/j.1477-2574.2012.00476.x | DOI Listing |
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