Background/Purpose

Two-stage hepatectomy (TSH), is associated with a risk of drop-out due to tumoral progression following portal vein occlusion (PVO). We explored the impact of majorhepatectomy on tumor growth by objective radiological measures comparing to PVO and minor hepatectomy, using a model of bilobar colorectal liver metastasis (CLM).

Methods

CLM were induced in 48 BDIX rats by injection of DHDK12-cells. 7 days after cells injection, animals were distributed into 4 groups of equal number (n = 12): portal vein ligation (PVL), sham laparotomy (sham), minor (30%Phx) and major (70%Phx) hepatectomy. MR imaging was used for in vivo analysis of tumor implantation, growth and volumes.

Results

At POD10, tumour volumes were homogeneously distributed among the 4 groups. Lower TV were significantly observed after 70%Phx comparing to PVL at POD17 (0.63 ± 0.14cm3 vs 0.9 ± 0.16cm3, p = 0.008) and to the 3 others groups at POD24: 1.78 ± 0.38cm3 vs 3.2 ± 0.62cm3 (PVL, p = 0.019), 2.41 ± 0.74cm3 (Sham, p = 0.024) and 2.32 ± 0.59cm3 (30%PHx, p = 0.019).

Conclusion

We confirmed in a reproducible model that contrary to PVO, a major hepatectomy decreases the growth of CLM in the remnant liver. This result leads to questioning the usual TSH and justifies exploring alternative strategies. The “major hepatectomy first-approach” should be an option to be evaluated.

中文翻译：

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双叶肝转移实验模型中的大肝切除术减少了肿瘤的生长

背景/目的

两阶段肝切除术 (TSH) 与门静脉闭塞 (PVO) 后肿瘤进展导致的退出风险相关。我们使用双叶结直肠肝转移 (CLM) 模型，通过与 PVO 和次要肝切除术相比的客观放射学测量，探讨了主要肝切除术对肿瘤生长的影响。

方法

通过注射 DHDK12 细胞在 48 只 BDIX 大鼠中诱导 CLM。细胞注射后 7 天，将动物分成 4 组，数量相等 (n = 12)：门静脉结扎 (PVL)、假剖腹手术 (sham)、小 (30%Phx) 和大 (70%Phx) 肝切除术。MR成像用于肿瘤植入、生长和体积的体内分析。

结果

在 POD10 时，肿瘤体积在 4 组中均匀分布。与 POD17 时的 PVL（0.63 ± 0.14cm3 与 0.9 ± 0.16cm3，p = 0.008）相比，在 70%Phx 后显着观察到较低的 TV，而与 POD24 的其他 3 组相比：1.78 ± 0.38cm3 与 3.2 ± 0.62cm3（PVL， p = 0.019)、2.41 ± 0.74cm3 (Sham, p = 0.024) 和 2.32 ± 0.59cm3 (30%PHx, p = 0.019)。

结论

我们在一个可重复的模型中证实，与 PVO 相反，大肝切除术会减少残肝中 CLM 的生长。这一结果导致质疑通常的 TSH 并证明探索替代策略的合理性。“主要肝切除术优先”应该是一个需要评估的选项。