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Characterization of early recurrences following liver resection by ALPPS and two stage hepatectomy in patients with colorectal liver-metastases and small future liver remnants; a translational substudy of the LIGRO-RCT
Oslo Univ Hosp, Norway.
Oslo Univ Hosp, Norway; Univ Oslo, Norway.
Oslo Univ Hosp, Norway.
Univ Oslo, Norway; Oslo Univ Hosp, Norway.
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2019 (English)In: HPB, ISSN 1365-182X, E-ISSN 1477-2574, Vol. 21, no 8, p. 1017-1023Article in journal (Refereed) Published
Abstract [en]

Background: Associated liver partition and portal vein ligation in staged hepatectomy (ALPPS) is an alternative resection method to portal vein embolization (PVE) in patients with small future liver remnants (FLR) but has been associated with early tumor recurrences. Methods: Twenty-four patients with colorectal liver metastases (CRLM) patients from the randomized multicenter LIGRO trial comparing outcome of ALPPS (n = 13) vs PVE (n = 11) were included in the study. Mutational analyses of the KRAS, NRAS, BRAF, PIC3CA and TP53 genes of the metastases were performed in 21 patients and correlated to early tumor recurrence. Results: Within 12 months, 13 patients experienced recurrences (6 in TSH group and 7 in ALPPS group). Nine of 13 patients with recurrences had mutations in the TP53 gene, while 3 of 8 patients without recurrence carried the same mutation. Only sporadic cases of the other mutations studied were identified. Conclusions: ALPPS did not appear to be associated with higher rate of rapid recurrences than PVE following radical resection of colorectal liver metastases. Mutations in genes associated with negative oncologic outcome after surgical resection most likely play a role for tumor recurrences in these patients.

Place, publisher, year, edition, pages
ELSEVIER SCI LTD , 2019. Vol. 21, no 8, p. 1017-1023
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Surgery
Identifiers
URN: urn:nbn:se:liu:diva-159870DOI: 10.1016/j.hpb.2018.12.003ISI: 000480420900010PubMedID: 30765198OAI: oai:DiVA.org:liu-159870DiVA, id: diva2:1346270
Note

Funding Agencies|Norwegian Cancer Society [182759-2016]; South-East Regional Health Trust, Norway; Norwegian Research Council [250993]

Available from: 2019-08-27 Created: 2019-08-27 Last updated: 2019-08-27

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Björnsson, BergthorSandström, Per
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Division of Surgery, Orthopedics and OncologyFaculty of Medicine and Health SciencesDepartment of Surgery in Linköping
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