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If someone has cancer in the liver, a surgeon can remove the affected part of the liver
Researchers from the departments of surgery and interventional radiology at Maastricht UMC+ have been investigating a new treatment method for a number of years that should ensure that more people with colon cancer that has spread to the liver can undergo surgery. Thanks to a second grant from the Dutch Cancer Society, they will now also investigate whether the method can be applied to people where the cancer started in the liver – a so-called primary liver tumor.
If someone has cancer in the liver, a surgeon can remove the affected part of the liver. But this is only possible if at least 30% of the liver remains. Thanks to research by an international consortium led by Maastricht UMC+ (MUMC+), the Dragon Trials Collaborative, these treatment options are being expanded.
Promising treatment
The healthy part that remains after the operation is called the residual liver. It has been possible for some time to grow the residual liver before surgery, so that more people have a chance of surgery. But the ‘old’ method for this – by cutting off the supply of blood via the portal vein in the affected part of the liver – only works in 60-75% of patients. With the new method, not only the supply, but also the drainage of blood via the hepatic vein is cut off. Initial research results show that up to 90% of patients with an initially too small residual liver can ultimately undergo the operation. Also read it article about one of the patients who participated in the study, with an explanation from researcher Remon Korenblik.
Primary liver tumors
The current study only focuses on patients with colon cancer that has metastasized to the liver. The researchers will now also apply the method to tumors that have arisen in the liver itself. These patients are more difficult to treat, explains Sinéad James, physician-researcher and PhD candidate at the department of surgery at MUMC+. ‘Primary liver tumors involve tumors in the bile ducts (cholangiocarcinoma) or in the liver tissue itself (hepatocellular carcinoma). Patients with these types of cancer are often sicker than if the cancer started somewhere else in the body and later entered the liver. For example, with a bile duct tumor, bile drainage is often blocked, causing patients to develop jaundice. With a tumor in the liver you often see that the patient is already weakened, which means that surgery is not an option for many patients. In short, primary and metastatic cancer in the liver are actually very different diseases, which is why we have to investigate in separate studies whether we can apply the method.’
364 patients
Coordinating researcher Sinéad James and the rest of the team are working with around 60 other hospitals in Europe, North America, Australia and Asia. Together they will treat 364 patients, half of whom will use the new method. The researchers then collect all data from the treatments, such as scans of the liver. In addition, the patients are followed for 5 years to gain insight into the possible recurrence of the cancer and survival of the patients. The researchers hope to be able to answer important questions about the added value of the new treatment method in people with primary liver tumors over the next three to seven years.
Dragon PLC (Primary Liver Cancer) Trial
The research, called DRAGON PLC trial, is the initiative of the MUMC+ and is led by surgical oncologist Dr. Ronald van Dam and interventional radiologist Dr. Christiaan van der Leij. The team, consisting of PhD students Drs. Remon Korenblik, Drs. Sinéad James and Jens Smits, and medical specialists Dr. Maxime Dewulf, Dr. Christiaan van der Leij and Dr. Ronald van Dam, recently received a prize for the expansion of the research a subsidy of €735,196 from the Dutch Cancer Society.
Bron: Maastricht UMC+
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2023-10-13 10:00:35
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