title: Portal vein embolisation with application of haematopoietic stem cells in patients with primarily or non-resectable colorectal liver metastases.
abstract: BACKGROUND
  Insufficient future liver remnant volume (FLRV) is the main cause of low resectability of liver metastases from colorectal cancer (CLMs). One option for enhancing FLVR growth is the use of portal vein embolisation (PVE) with the application of autologous haematopoietic stem cells (HSCs).
  
  
  METHODS
  PVE with the application of HSCs was used in 11 patients (group 1) with primarily non-resectable CLMs due to insufficient FLRV without signs of extrahepatic metastases. The control group (group 2) consisted of 14 patients in whom only PVE was performed. We evaluated the product quality, FLRV growth, CLM volume, median survival and progression-free survival (PFS).
  
  
  RESULTS
  Product quality was achieved in all collections. In all group-I patients, sufficient FLRV growth occurred within three weeks. In the first and second weeks, FLRV increased optimally in most patients (p<0.006). In 13 out of the 14 group-2 patients, optimum FLVR growth was observed within three weeks following PVE (p<0.002). More rapid FLVR growth was observed in group 1 patients (p<0.01). CLM volume was significantly increased in both the group-2 (p<0.0005) and group-1 (p<0.008) patients at the time of liver resection. There was no significant difference in the growth of the CLM volume between the groups (p<0.18). The median survival was 7.3 and 6.8 months for group 1 and 2 patients, respectively, and the two-year PFS was 28% and 22% (p<0.18), respectively.
  
  
  CONCLUSIONS
  PVE with HSC application is a promising method for effectively stimulating FLRV growth in patients with primarily non-resectable CLMs.
authors.affiliation: Department of Surgery, University Hospital, Faculty of Medicine in Pilsen, Pilsen, Czech Republic treska@fnplzen.cz.
authors.forename: Vladislav
authors.initials: V
authors.lastname: Treska
authors.affiliation: Department of Surgery, University Hospital, Faculty of Medicine in Pilsen, Pilsen, Czech Republic.
authors.forename: Vaclav
authors.initials: V
authors.lastname: Liska
authors.affiliation: Department of Surgery, University Hospital, Faculty of Medicine in Pilsen, Pilsen, Czech Republic.
authors.forename: Jakub
authors.initials: J
authors.lastname: Fichtl
authors.affiliation: Department of Hematooncology, University Hospital, Faculty of Medicine in Pilsen, Pilsen, Czech Republic.
authors.forename: Daniel
authors.initials: D
authors.lastname: Lysak
authors.affiliation: Radiodiagnostic Clinic, University Hospital, Faculty of Medicine in Pilsen, Pilsen, Czech Republic.
authors.forename: Hynek
authors.initials: H
authors.lastname: Mirka
authors.affiliation: Department of Surgery, University Hospital, Faculty of Medicine in Pilsen, Pilsen, Czech Republic.
authors.forename: Jan
authors.initials: J
authors.lastname: Bruha
authors.affiliation: Radiodiagnostic Clinic, University Hospital, Faculty of Medicine in Pilsen, Pilsen, Czech Republic.
authors.forename: Petr
authors.initials: P
authors.lastname: Duras
authors.affiliation: Department of Surgery, University Hospital, Faculty of Medicine in Pilsen, Pilsen, Czech Republic.
authors.forename: Inka
authors.initials: I
authors.lastname: Treskova
authors.affiliation: Department of Surgery, University Hospital, Faculty of Medicine in Pilsen, Pilsen, Czech Republic.
authors.forename: Jakub
authors.initials: J
authors.lastname: Nahlik
authors.affiliation: Department of Surgery, University Hospital, Faculty of Medicine in Pilsen, Pilsen, Czech Republic.
authors.forename: Vaclav
authors.initials: V
authors.lastname: Simanek
authors.affiliation: Laboratory of Immunoanalysis, University Hospital, Faculty of Medicine in Pilsen, Pilsen, Czech Republic.
authors.forename: Ondrej
authors.initials: O
authors.lastname: Topolcan
mesh_terms: D000368:Aged; D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D018572:Disease-Free Survival; D004621:Embolization, Therapeutic; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006412:Hematopoietic Stem Cells; D006498:Hepatectomy; D006801:Humans; D007937:Leukapheresis; D008099:Liver / Q000098:blood supply / Q000473:pathology / Q000601:surgery; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary / Q000628:therapy*; D008115:Liver Regeneration; D008297:Male; D008875:Middle Aged; D011169:Portal Vein
keywords: Colorectal liver metastases; future liver remnant volume; haematopoietic stem cells; portal vein embolisation