Research Of Impact Of Portal Vein Ligation On Liver Regeneration And Tumor Growth In Different Liver Lobe

Backgroud:Preoperative portal vein embolization (PVE) is performed to minimize perioperative risks of major hepatic resection for hepatocellular carcinoma (HCC), but its effects on tumor growth are ill defined. In this study,PVE and Portal vein ligation(PVL) were used to evaluate the impact on liver regeneration and tumor growth in different liver lobe in clinic and experiment part separately.Method:clinic part, Patients that underwent right half hepatic resection for HCC between1999and2008were analyzed retrospectively. Preoperative PVE was performed when the remnant liver volume was predicted to be insufficient. CT scan was used to calculate the tumor volume and tomor growth rate.Experiment part, Twenty-seven male rats were equally divided into3groups. Nine non HCC rats served as a control (group A). Hepatocellular carcinoma was induced in18rats (group B,C).PVL was performed in group A and group C.Sham operations were performed in group B. The hepatic lobe and tumor volume changes were tested with PET scans in different time after PVL.Result:First part, A total of64patients underwent right half hepatic resection for HCC.28patients with PVE with resection(A group) and36patients without PVE(B group).Median follow-up was28months. In A group, the tumor volume in right hepatic was higher after PVE (174.7±13.4m vs.94.5±11.2ml, P<0.05). The overall survival rate at1,3,5years were91%、64%、56%, respectively,in the A group and92%、61%、49%, respectively, in the B groups.(P>0.05).Second part, The volume of tumors in the ligated lobes of group C were significantly larger than that of the group B after PVL,(54.90±32.17VS28.41±11.04mm3,P<0.05). However, there was no significant difference in the non-ligated lobes (P>0.05). The differences between the volume of tumors and tumor growth rate in non-ligated lobes were insignificant between group B and C(P>0.05).Conclusions1. The overall survival rate was similar between PVE and non-PVE group.2. PVL can progress tumor growth in the ligated lobe in the HCC animal model, but not in the non-ligated lobe.