Effect of portal vein embolisation on the growth rate of colorectal liver metastases

V. Pamecha, A. Levene, F. Grillo, N. Woodward, A. Dhillon, B. R. Davidson

Research output: Contribution to journalArticle

Abstract

Portal vein embolisation (PVE) is used to increase the remnant liver volume before major liver resection for colorectal metastases. The resection rate after PVE is 60-70%, mainly limited by disease progression. The effect of PVE on tumour growth rate has not been investigated. The objective of this study was to compare the growth characteristics of resected colorectal liver metastases in patients undergoing pre-operative PVE with those of matched controls who had not undergone PVE. There were 22 patients who had undergone preoperative PVE and 20 matched controls. Tumour growth rate was calculated by the change in tumour volume (CT/MRI volumetric assessment) from diagnosis to resection. Resected histological specimens were examined by two histopathologists independently for cell differentiation, percentage tumour cell necrosis and mitotic rate. Immunochemical staining with Ki67 was carried out using the MIB-1 monoclonal antibody and quantified using a Glasgow cell-counting graticule. The groups were comparable in demographics, stage of primary disease, volume of liver metastases at presentation and chemotherapy received. The tumour growth rate calculated from imaging was more rapid in the PVE group compared with that in controls (control: 0.05±0.25 ml day-1, PVE: 0.36±0.68 ml day-1, P=0.06). Histology showed no difference in the degree of differentiation, extent of necrosis or apoptosis between the two groups. However, mitotic rate was higher post PVE, as was the proliferation index Ki67 (P=0.04). This study has confirmed that tumour growth rate increased following PVE and that this is related to increased tumour cell division.

Original languageEnglish
Pages (from-to)617-622
Number of pages6
JournalBritish Journal of Cancer
Volume100
Issue number4
DOIs
Publication statusPublished - Feb 24 2009

Fingerprint

Portal Vein
Neoplasm Metastasis
Liver
Growth
Neoplasms
Necrosis
Cone-Beam Computed Tomography
Tumor Burden
Cell Division
Disease Progression
Liver Diseases
Cell Differentiation
Histology
Demography
Apoptosis
Staining and Labeling
Drug Therapy

Keywords

  • Colorectal liver metastases
  • Liver resection
  • Portal vein embolisation

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Effect of portal vein embolisation on the growth rate of colorectal liver metastases. / Pamecha, V.; Levene, A.; Grillo, F.; Woodward, N.; Dhillon, A.; Davidson, B. R.

In: British Journal of Cancer, Vol. 100, No. 4, 24.02.2009, p. 617-622.

Research output: Contribution to journalArticle

Pamecha, V. ; Levene, A. ; Grillo, F. ; Woodward, N. ; Dhillon, A. ; Davidson, B. R. / Effect of portal vein embolisation on the growth rate of colorectal liver metastases. In: British Journal of Cancer. 2009 ; Vol. 100, No. 4. pp. 617-622.
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