The paradigm of tumor shrinkage and rapid liver remnant hypertrophy for conversion of initially unresectable colorectal liver metastasis: a case report and literature review

World Journal of Surgical Oncology

Case Report

Shuyou Peng¹  Liuhong Wang²  Jianjun Wu²  Shaojun Yu³  Jianwei Wang³  Jian Wang³  Nan Xiao³  Kailin Yu³  Shuchun Zheng³  Siyang Shan³ 

[1] Department of General Surgery, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China;Department of Radiology and Intervention, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China;Department of Surgical Oncology, Second Affiliated Hospital of Zhejiang University School of Medicine, 310009, Hangzhou, China;

关键词: Tumor shrinkage;    Liver remnant hypertrophy;    Unresectable colorectal liver metastasis;    Preoperative chemotherapy;   

DOI  :  10.1186/s12957-017-1212-6

 received in 2017-04-18, accepted in 2017-07-22,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundFor colorectal liver metastasis (CRLM) patients, hepatic resection is currently the sole cure offering the chance of long-term survival. Tumor shrinkage and planned liver remnant hypertrophy are the two key strategies for conversion of initially unresectable CRLM. First conducted in 2012, associated liver partition and portal vein ligation for staged hepatectomy (ALPPS) allows rapid liver growth. As a means to induce hypertrophy, portal vein embolization (PVE) has been widely applied before extending hepatectomy. Recently, Peng et al. present a new approach of terminal branches portal vein embolization (TBPVE), offering an efficient way to amplify FLR and making chances for surgery in 2 weeks.Case presentationWe reported a 61-year-old woman with synchronous hepatic metastasized carcinoma of the colon sigmoideum underwent TBPVE after 6 cycles of neoadjuvant therapy in order to perform a planned right trisectionectomy. Rapid liver remnant hypertrophy and remarkable tumor shrinkage were achieved, and laparoscopic sigmoidectomy and right trisectionectomy were successfully performed. The postsurgical course was uneventful and 7 months of recurrence-free survival have been witnessed.ConclusionsThe dual tactics of tumor shrinkage and planned rapid liver remnant hypertrophy will make concerted efforts to further increase the clinical candidacy for curative resection, which are valuable for further investigation.

【 授权许可】

CC BY   
© The Author(s). 2017