Department of Surgery, University Hospital, Faculty of Medicine in Pilsen, Pilsen, Czech Republic
Department of Surgery, University Hospital, Faculty of Medicine in Pilsen, Pilsen, Czech Republic.
Anticancer Res. 2014 Dec;34(12):7279-85.
Insufficient future liver remnant volume (FLRV) is the main cause of low resectability of liver metastases from colorectal cancer (CLMs). One option for enhancing FLVR growth is the use of portal vein embolisation (PVE) with the application of autologous haematopoietic stem cells (HSCs).
PVE with the application of HSCs was used in 11 patients (group 1) with primarily non-resectable CLMs due to insufficient FLRV without signs of extrahepatic metastases. The control group (group 2) consisted of 14 patients in whom only PVE was performed. We evaluated the product quality, FLRV growth, CLM volume, median survival and progression-free survival (PFS).
Product quality was achieved in all collections. In all group-I patients, sufficient FLRV growth occurred within three weeks. In the first and second weeks, FLRV increased optimally in most patients (p<0.006). In 13 out of the 14 group-2 patients, optimum FLVR growth was observed within three weeks following PVE (p<0.002). More rapid FLVR growth was observed in group 1 patients (p<0.01). CLM volume was significantly increased in both the group-2 (p<0.0005) and group-1 (p<0.008) patients at the time of liver resection. There was no significant difference in the growth of the CLM volume between the groups (p<0.18). The median survival was 7.3 and 6.8 months for group 1 and 2 patients, respectively, and the two-year PFS was 28% and 22% (p<0.18), respectively.
PVE with HSC application is a promising method for effectively stimulating FLRV growth in patients with primarily non-resectable CLMs.
肝脏转移性结直肠癌（CLM）切除率低的主要原因是未来肝残留体积（FLRV）不足。一种增加 FLVR 生长的方法是使用门静脉栓塞术（PVE）并应用自体造血干细胞（HSCs）。
11 例主要因 FLRV 不足而非肝转移性结直肠癌（CLM）无法切除的患者（1 组）采用 PVE 联合 HSCs 治疗，无肝外转移迹象。对照组（2 组）包括 14 例仅行 PVE 的患者。我们评估了产品质量、FLRV 生长、CLM 体积、中位生存时间和无进展生存时间（PFS）。
所有采集均达到了产品质量标准。在所有 1 组患者中，均在 3 周内实现了足够的 FLRV 生长。在第一和第二周，大多数患者的 FLRV 最佳增加（p<0.006）。在 14 例 2 组患者中，在 PVE 后 3 周内观察到最佳的 FLRV 生长（p<0.002）。1 组患者的 FLRV 生长更快（p<0.01）。在进行肝切除时，2 组（p<0.0005）和 1 组（p<0.008）患者的 CLM 体积均显著增加。两组之间 CLM 体积的生长无显著差异（p<0.18）。1 组和 2 组患者的中位生存时间分别为 7.3 个月和 6.8 个月，两年无进展生存率分别为 28%和 22%（p<0.18）。
PVE 联合 HSCs 应用是一种很有前途的方法，可以有效地刺激主要不可切除的 CLM 患者的 FLRV 生长。
