Evidence map›Paper›PMID 30465187›Full record

Trial reportJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2019

Future Liver Remnant (FLR) Increase in Patients with Colorectal Liver Metastases Is Highest the First Week After Portal Vein Occlusion : FLR Increase in Patients with CRLM Is Highest the First Week After PVO.

Kristina Hasselgren, Per Sandström, Bård Ingvald Røsok, Ernesto Sparrelid, Gert Lindell, Peter Nørgaard Larsen, Anna Lindhoff Larsson, Nicolai A Schultz, Bjorn Atle Björnbeth, Bengt Isaksson and 2 more

Abstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Kristina HasselgrenDepartments of Surgery and Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
Per SandströmDepartments of Surgery and Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
Bård Ingvald RøsokDepartment of Hepato-Pancreato-Biliary Surgery, Oslo University Hospital, Oslo, Norway.
Ernesto SparrelidDepartment of Clinical Science, Intervention and Technology, Division of Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
Gert LindellDepartment of Surgery, Skane University Hospital, Lund, Sweden.
Peter Nørgaard LarsenDepartment of Surgical Gastroenterology and Transplantation, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
Anna Lindhoff LarssonDepartments of Surgery and Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
Nicolai A SchultzDepartment of Surgical Gastroenterology and Transplantation, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
Bjorn Atle BjörnbethDepartment of Hepato-Pancreato-Biliary Surgery, Oslo University Hospital, Oslo, Norway.
Bengt IsakssonDepartment of Surgery, Akademiska University Hospital, Uppsala, Sweden.
Magnus RizellDepartment of Transplantation and Liver Surgery, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Bergthor BjörnssonDepartments of Surgery and Clinical and Experimental Medicine, Linköping University, Linköping, Sweden. bergthor.bjornsson@liu.se.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPortal vein occlusion (PVO) is an established method to increase the volume of the future liver remnant (FLR). The main reasons for not proceeding to radical hepatectomy are lack of volume increase and tumor progression due to a wait-time interval of up to 8 weeks. The hypothesis was that the increase in FLR volume is not linear and is largest during the first weeks.

methodsPatients with colorectal liver metastases (CRLM) and standardized future liver remnant (sFLR) < 30% treated with PVO were prospectively included. All patients had at least one CT evaluation before radical hepatectomy.

resultsForty-eight patients were included. During the first week after PVO, the kinetic growth rate (KGR) was 5.4 (± 4), compared to 1.5 (± 2) between the first and second CT (p < 0.05). For patients reaching adequate FLR and therefore treated with radical hepatectomy, the KGR was 7 (± 4) the first week, compared to 4.3 (± 2) for patients who failed to reach a sufficient volume (p = 0.4). During the interval between the first and second CT, the KGR was 2.2 (± 2), respectively (± 0.1) (p = 0.017). DISCUSSION: The increase in liver volume after PVO is largest during the first week. As KGR decreases over time, it is important to shorten the interval between PVO and the first volume evaluation; this may aid in decision-making and reduce unnecessary waiting time.

Indexed as

Liver RegenerationAgedColorectal NeoplasmsFemaleFollow-Up StudiesHepatectomyHumansLigationLiver NeoplasmsMaleNeoplasm MetastasisPortal VeinPostoperative PeriodTime FactorsTomography, X-Ray ComputedColorectal liver metastasesFuture liver remnantLiver surgeryPortal vein embolizationPortal vein ligation

Identifiers

PMID30465187
PMCPMC6414468

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.