Liver Histology Predicts Liver Regeneration and Outcome in ALPPS: Novel Findings from A Multicenter Study.
Journal
Annals of surgery
ISSN: 1528-1140
Titre abrégé: Ann Surg
Pays: United States
ID NLM: 0372354
Informations de publication
Date de publication:
24 Jul 2023
24 Jul 2023
Historique:
pubmed:
24
7
2023
medline:
24
7
2023
entrez:
24
7
2023
Statut:
aheadofprint
Résumé
Alterations in liver histology influence the liver´s capacity to regenerate, but the relevance of each of the different changes rapid liver growth induction is unknown. This study aimed to analyze the influence of the degree of histological alterations during the first and second stages on the ability of the liver to regenerate. This cohort study included data obtained from the International ALPPS Registry between November 2011 and October 2020. Only patients with colorectal liver metastases were included in the study. We developed a histological risk score based on histological changes (stages 1 and 2) and a tumor pathology score based on the histological factors associated with poor tumor prognosis. In total, 395 patients were included. The time to reach stage 2 was shorter in patients with a low histological risk stage 1 (13 vs. 17 d, P ˂0.01), low histological risk stage 2 (13 vs. 15 d, P ˂0.01) and low pathological tumor risk (13 vs. 15 d, P ˂0.01). Regarding interval stage, there was a higher inverse correlation in high histological risk stage 1 group compared to low histological risk 1 group in relation with future liver remnant body weight (r=-0.1 and r=-0.08, respectively), and future liver remnant (r=-0.15 and r=-0.06, respectively). ALPPS is associated with increased histological alterations in the liver parenchyma. It seems that the more histological alterations present and the higher the number of poor prognostic factors in the tumor histology, the longer the time to reach the second stage.
Sections du résumé
BACKGROUND AND AIMS
OBJECTIVE
Alterations in liver histology influence the liver´s capacity to regenerate, but the relevance of each of the different changes rapid liver growth induction is unknown. This study aimed to analyze the influence of the degree of histological alterations during the first and second stages on the ability of the liver to regenerate.
METHODS
METHODS
This cohort study included data obtained from the International ALPPS Registry between November 2011 and October 2020. Only patients with colorectal liver metastases were included in the study. We developed a histological risk score based on histological changes (stages 1 and 2) and a tumor pathology score based on the histological factors associated with poor tumor prognosis.
RESULTS
RESULTS
In total, 395 patients were included. The time to reach stage 2 was shorter in patients with a low histological risk stage 1 (13 vs. 17 d, P ˂0.01), low histological risk stage 2 (13 vs. 15 d, P ˂0.01) and low pathological tumor risk (13 vs. 15 d, P ˂0.01). Regarding interval stage, there was a higher inverse correlation in high histological risk stage 1 group compared to low histological risk 1 group in relation with future liver remnant body weight (r=-0.1 and r=-0.08, respectively), and future liver remnant (r=-0.15 and r=-0.06, respectively).
CONCLUSION
CONCLUSIONS
ALPPS is associated with increased histological alterations in the liver parenchyma. It seems that the more histological alterations present and the higher the number of poor prognostic factors in the tumor histology, the longer the time to reach the second stage.
Identifiants
pubmed: 37487004
doi: 10.1097/SLA.0000000000006024
pii: 00000658-990000000-00595
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
Conflicts of interest: The authors declare no conflicts of interest. No third-party financial funds or materials were accepted or necessary for this research project.