Liver regeneration and liver metastasis. (June 2021)

• Record Type: Journal Article
• Authors: Riddiough, Georgina E; Jalal, Qaiser; Perini, Marcos V; Majeed, Ali W
• Is Part Of: Seminars in cancer biology. Volume 71(2021)
• Page Start: 86
• Page End: 97
• Publication Date: 2021-06
• Subjects: ALPPS associating liver partition and portal vein ligation for staged hepatectomy -- AP-1 activated protein 1 -- CEA carcinoembryonic antigen -- CRLM colorectal liver metastasis -- FLR future liver remnant -- HGF hepatocyte growth factor -- Hh Hedgehog -- IL-6 interleukin 6 -- NF‐κB nuclear factor kappa B -- PHx partial hepatectomy -- PVE portal vein embolisation -- SFSS small for size syndrome -- TGF transforming growth factor -- TNF tumour necrosis factor -- TSH two stage hepatectomy; Liver regeneration -- Liver metastasis -- Surgical oncology -- Hepatic resection; Cancer -- Periodicals; Neoplasms -- Periodicals; Review Literature; Cancer -- Périodiques; Electronic journals; 616.994
• DOI: 10.1016/j.semcancer.2020.05.012
• Languages: English
• ISSNs: 1044-579X

Abstract

Abstract: Surgical resection for primary and secondary hepatic neoplasms provides the best chance of cure. Advanced surgical techniques such as portal vein embolisation, two-staged hepatectomy and associated liver partition and portal vein ligation for staged-hepatectomy (ALPPS) have facilitated hepatic resection in patients with previously unresectable, bi-lobar disease. These techniques are frequently employed to ensure favourable clinical outcomes and avoid potentially fatal post-operative complications such as small for size syndrome and post-hepatectomy liver failure. However, they rely on the innate ability of the liver to regenerate. As our knowledge of liver organogenesis, liver regeneration and hepatocarcinogenesis has expanded in recent decades it has come to light that liver regeneration may also drive tumour recurrence. Clinical studies in patients undergoing portal vein embolisation indicate that tumours may progress following the procedure in concordance with liver regeneration and hypertrophy, however overall survival in these patients has not been shown to be worse. In this article, we delve into the mechanisms underlying liver regeneration to better understand the complex ways in which this may affect tumour behaviour and ultimately inform clinical decisions.