TY - JOUR
T1 - Liver Histology Predicts Liver Regeneration and Outcome in ALPPS
T2 - Novel Findings From A Multicenter Study
AU - Lopez-Lopez, Victor
AU - Linecker, Michael
AU - Caballero-Llanes, Albert
AU - Reese, Tim
AU - Oldhafer, Karl J.
AU - Hernandez-Alejandro, Roberto
AU - Tun-Abraham, Mauro
AU - Li, Jun
AU - Fard-Aghaie, Mohammad
AU - Petrowsky, Henrik
AU - Brusadin, Roberto
AU - Lopez-Conesa, Asuncion
AU - Ratti, Francesca
AU - Aldrighetti, Luca
AU - Ramouz, Ali
AU - Mehrabi, Arianeb
AU - Autran MacHado, Marcel
AU - Ardiles, Victoria
AU - de Santibañes, Eduardo
AU - Marichez, Arthur
AU - Adam, René
AU - Truant, Stéphanie
AU - Pruvot, Francois-René
AU - Olthof, Pim B.
AU - van Gulick, Thomas M.
AU - Montalti, Roberto
AU - Troisi, Roberto I.
AU - Kron, Philipp
AU - Lodge, Peter
AU - Kambakamba, Patryk
AU - Hoti, Emir
AU - Martinez-Caceres, Carlos
AU - de la Peña-Moral, Jesus
AU - Clavien, Pierre-Alain
AU - Robles-Campos, Ricardo
N1 - Publisher Copyright: © 2024 Lippincott Williams and Wilkins. All rights reserved.
PY - 2024/2/1
Y1 - 2024/2/1
N2 - Background and Aims: Alterations in liver histology influence the liver's capacity to regenerate, but the relevance of each of the different changes in 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: 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: 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 days, P0.01), low histological risk stage 2 (13 vs 15 days, P<0.01), and low pathological tumor risk (13 vs 15 days, 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). 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.
AB - Background and Aims: Alterations in liver histology influence the liver's capacity to regenerate, but the relevance of each of the different changes in 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: 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: 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 days, P0.01), low histological risk stage 2 (13 vs 15 days, P<0.01), and low pathological tumor risk (13 vs 15 days, 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). 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.
KW - ALPPS
KW - colorectal liver metastases
KW - histology
KW - liver regeneration
KW - liver resection
KW - oncological outcomes
UR - http://www.scopus.com/inward/record.url?scp=85182091212&partnerID=8YFLogxK
U2 - https://doi.org/10.1097/SLA.0000000000006024
DO - https://doi.org/10.1097/SLA.0000000000006024
M3 - Article
C2 - 37487004
SN - 0003-4932
VL - 279
SP - 306
EP - 313
JO - Annals of surgery
JF - Annals of surgery
IS - 2
ER -