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Ischemia/reperfusion accelerates the outgrowth of hepatic micrometastases in a highly standardized murine model
Author(s) -
van der Bilt Jarmila D. W.,
Kranenburg Onno,
Nijkamp Maarten W.,
Smakman Niels,
Veenendaal Liesbeth M.,
te Velde Elisabeth A.,
Voest Emile E.,
van Diest Paul J.,
Borel Rinkes Inne H. M.
Publication year - 2005
Publication title -
hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.488
H-Index - 361
eISSN - 1527-3350
pISSN - 0270-9139
DOI - 10.1002/hep.20739
Subject(s) - medicine , hepatocellular carcinoma , necrosis , hepatology , ischemia , pathology , liver lobe , hepatectomy , colorectal cancer , liver regeneration , cancer , surgery , biology , regeneration (biology) , resection , microbiology and biotechnology
Mortality in colorectal cancer is associated with the development of liver metastases. Surgical removal of these tumors is the only hope for cure, but recurrence is common. During liver surgery, ischemia/reperfusion (I/R) often occurs as a result of hemorrhage or vascular clamping. Although the adverse effects of I/R on postoperative liver function are well documented, the influence of I/R on the outgrowth of residual micrometastases is unknown. We used a highly standardized mouse model of partial hepatic I/R to study the effects of I/R on the outgrowth of preestablished colorectal micrometastases. Five days following intrasplenic injection of C26 colon carcinoma cells, the vascular structures of the left lobe were clamped for 45 minutes under hemodynamically stable conditions. Tissue glutathione, plasma liver enzymes, hepatocellular necrosis, and tumor growth were assessed over time. I/R caused oxidative stress and early liver tissue damage. The outgrowth of micrometastases in occluded liver lobes was accelerated five‐ to sixfold compared with nonoccluded lobes and was associated with areas of necrotic liver tissue surrounded by inflammatory cells and apoptotic hepatocytes. Accelerated tumor growth and tissue necrosis were completely prevented by occluding blood flow intermittently. In contrast, ischemic preconditioning or treatment with the antioxidants α‐tocopherol or ascorbic acid failed to protect against late tissue necrosis and tumor growth, although early hepatocellular damage was largely prevented by these methods. In conclusion , I/R is a strong stimulus of recurrent intrahepatic tumor growth. Measures to prevent I/R‐induced late tissue necrosis cross‐protect against this phenomenon. (H EPATOLOGY 2005;42:165–175.)