Abstract
ALPPS on tumor proliferation remains a concern. The aim of this study was to investigate the impact of ALPPS on tumor growth in mice. Methods: The effect of ALPPS and 90% portal vein ligation (PVL) on colorectal liver and lung metastases was investigated in C57BL/6 mice. In vivo tumor progression was assessed by small animal magnetic resonance imaging (sMRI), histology and survival experiments. The effect of ALPPS, PVL and control sera onMC38 andCT26 colorectal cancer cell-lines was subsequently tested in vitro. One-way ANOVA test was used for comparison of multiple groups. Results: At day 14 and 21 after ALPPS, PVL or sham surgery, sMRI showed similar intrahepatic tumor numbers (p = 0.56/0.53), sizes (p = 0.45/0.98) and growth kinetics (p = 0.58/0.68). For both time points median tumor size in non-occluded lobes was similar in ALPPS and PVL groups as well as in the corresponding lobe in the sham group (2.4mm/12.3mm vs. 3.9mm/14.4mm vs. 4.5mm/14.9mm, p = 0.511/0.918). Median survival after tumor cell injection was not different between sham surgery and completion of ALPPS and PVL (36 days (IQR32-40) vs. 42 days (IQR36e48) vs. 39days (IQR35-42), p = 0.237). Likewise, pulmonary tumor load and in vitro cell proliferation were similar. Conclusion: This study provides evidence that ALPPS does not accelerate tumor growth rates compared with conventional two-stage procedure.
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