Třeška V., Topolčan O., Vrzalová J., Pešta M., Liška V., Skalický T., Sutnar A., Fichtl J., Ňaršanská A., Polák M., Vachtová M., Doležal J., Šlauf F., Ferda J., Mírka H.: Can Tumor Markers Predict Outcomes of Portal Vein Branch Embolization in Patients with Primary Inoperable Liver Tumors?
Authors:
V. Třeška; O. Topolčan 1; J. Vrzalová 1; F. Šlauf 2; V. Liška; T. Skalický; A. Sutnar; J. Fichtl; A. Ňaršanská; M. Vachtová
Authors‘ workplace:
Chirurgická klinika FN a LF UK v Plzni, přednosta: prof. MUDr. V. Třeška, DrSc.
; Úsek imunoanalýzy a CRL FN a LF UK v Plzni, přednosta: prof. MUDr. O. Topolčan, CSc.
1; Radiodiagnostická klinika LF UK a FN v Plzni, přednosta: doc. MUDr. B. Kreuzberg, CSc.
2
Published in:
Rozhl. Chir., 2011, roč. 90, č. 5, s. 285-289.
Category:
Monothematic special - Original
Overview
Introduction:
Portal vein embolization (PVE) is one of the options to increase the number of resecable cases in patients with primary inoperable liver tumors. However, insufficient growth of liver parenchyma or postoperative tumor progression remains problematic in PVE procedures. Generally, tumor markers are of significance in patient postoperative monitoring for the disease recurrence. The aim of this study is to assess the potential of tumor markers in predicting PVE outcomes.
Method:
The study group included 43 subjects with primary or secondary tumors, in whom serum α-fetoprotein (AFP), carcinoembryonic antigen (CEA), thymidine kinase (TK), tissue polypetide antigen (TPS) and MonoTotal levels were assessed 28 days following PVE. The liver parenchyma growth or tumor progression were assessed based on computer tomography.
Results:
Sufficient liver parenchyma hypertrophy was recorded in 27 (62.8 %) patients with subsequent liver resection. Insufficient post-PVE liver parenchyma growth was recorded in 5 (11.6 %) patients and tumor progression was recorded in 11 (25.6 %) subjects. The following tests were considered significant predictive tumor markers of PVE outcomes: serum levels of CEA, TPA, Mono Total prior to PVE, and serum levels of TK, TPA, Mono Total within 28 days following PVE.
Conclusion:
Tumor markers may be significant in predicting PVE outcomes in patients with primary inoperable liver tumors. However, in order to make final conclusions on their clinical significance, larger patient group studies should be performed.
Key words:
tumor markers – portal vein branch embolization – liver hypertrophy – tumor progression
Sources
1. Gilson, N., Honoré, C., De Roover, A., Coimbra, C., Kohnen, L., Polus, M., Piront, P., van Daele, D., Honoré, P., Meurisse, M. Surgical management of hepatic metastases of colorectal origin. Acta gastro-enterol. belg., 2009; 72: 321–326.
2. Makuuchi, M., Thai, B. L., Takayasu, K. Preoperative portal vein embolization to increase safety of major hepatectomy for hilar bile duct carcinoma: a preliminary report. Surgery, 1990; 107: 521–527.
3. Shimada, H., Tanaka, K., Endou, I., Ichikawa, Y. Treatment for colorectal liver metastases: a review. Langenbecks Arch Surg, 2009; 394: 973–983.
4. Třeška, V., Skalický, T., Sutnar, A., Liška, V. Chirurgická léčba jaterních metastáz kolorektálního karcinomu. Rozhl. Chir., 2009; 88: 69–75.
5. Neumann, U. P., Seehofer, D., Neuhaus, P. The surgical treatment of hepatic metastases in colorectal carcinoma. Dtsch. Arztbl. Int., 2010; 107: 335–342.
6. Shim, J. H., Park, J. W., Kim, J. H., An, M., Kong, S. Y., Nam, B. H., Choi, J. I., Kim, H. B., Lee, W. J., Kim, C. M. Association between incrwement of serum VEGF level and prognosis after transcatheter arterial chemoembolization in hepatocellular carcinoma patients. Cancer Sci., 2008; 99: 2037–2044.
7. Lygidakis, N. J., Bhagat, A. D., Vrachnos, P., Grikorakos, L. Challenges in everyday surgical practice: Synchronous bilobar hapatic colorectal metastases – newer multimodality approach. Hepato-Gastroenterology, 2007; 54: 1020–1024.
8. Kokudo, N., Tada, K., Seki, M., Ohta, H., Azekura, K., Ueno, M., Ohta, K., Yamaguchi, T., Matsubara, T., Takanashi, T., Nakajima, T., Muto, T., Ikari, T., Yanagisawa, A., Kato, Y. Proliferative activity of intrahepatic colorectal metastases after preoperative hemihepatic portal vein embolization. Hepatology, 2001; 34: 267–272.
9. Liu, H., Zhu, S. Present status and future perspectives of preoperative portal vein embolization. Am. J. Surg., 2009; 197: 686–690.
10. Hayashi, S., Baba, Y., Ueno, K. Acceleration of primary liver tumor growth rate in embolized hepatic lobe after portal vein embolization. Acta Radiol., 2007; 48: 721–727.
11. Ribero, D., Abdalla, E. K., Madoff, D. C., Donadon, M., Loyeer, E. M., Vauthey, J. N. Portal vein embolization before major hepatectomy and its effects on regeneration. Br. J. Surg., 2007;94: 1386–1394.
12. Liu, H., Zhu, S. Present status and future perspectives of preoperative portal vein embolization. Am. J. Surg., 2009; 197: 686–690.
13. Gulik, T., Esschert, J. W., Graaf, W., Lienden, K. P., Busch, O. R. C., Heger, M., Delden, O. M., Laméris, J., Gouma, D. J. Controversies in the use of portal vein embolization. Dig. Surg., 2008; 25: 436–444.
14. Yokoyama, Y., Nagino, M., Nimura, Y. Mechanisms of hepatic regeneration following portal vein embolization and partial hepatectomy: a review. World J. Surg., 2007; 31: 367–374.
15. Schetter, A. J, Nguyen, G. H., Mathé, E. A., Yuen, S. T., Hawkes, J. E., Croce, C. M., Leung, S. Y., Harris, C. C. Association of inflammation-related and microRNA gene expression with cancer-specific mortality of colon adenocarcinoma. Clin. Cancer Res., 2009; 15: 5878–5887.
16. Aarons, C. B., Bajenova, O., Andrews, C., Heydrick, S., Bushell, K. N., Red, K. L., Thomas, P., Becker, J. M., Stucchi, A. F. Carcinoembryonic antigen-stimulated THP-1 macrophages activate endothelial cells and increase cell-cell adhesion of colorectal cancer cells. Clin. Exp. Metastasis, 2007; 24: 201–209.
17. Holubec, L. jr,, Topolčan, O., Pikner, R. Biologická aktivita kolorektálního karcinomu. Cas. Lek. Ces., 2002; 141: 508–512.
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Surgery Orthopaedics Trauma surgeryArticle was published in
Perspectives in Surgery
2011 Issue 5
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