Impact of Portal Vein Embolization on Long-Term Outcome in Patients with Colorectal Liver Metastases

Yaacov Goykhman1#, Saeed Sirhan2#, Alex Barenboim2, Isaac Kori3, Sharon Peles-Avraham4, Guy Lahat2, Michal Shimonovich2, Joseph M Klausner2, Menahem Ben-Haim5# and Nir Lubezky1*#

1Department of HPB and Transplant Surgery, Tel-Aviv Medical Center, Affiliated to the Sackler School of Medicine,Tel Aviv University, Israel
2Division of Surgery, Tel-Aviv Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Israel
3Unit of Invasive Radiology, Tel-Aviv Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Israel
4Institute of Oncology, Tel-Aviv Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Israel
5Department of Surgery, Shaarey Zedek Medical Center, Israel
#These authors contributed equally to this work

^*Correspondance to: Nir Lubezky 

 PDF  Full Text DOI: 10.25107/2474-1647.3508

Abstract

Background: Portal Vein Embolization (PVE) is used to increase Future Liver Remnant (FLR) volume before major liver resection. There is concern that PVE may stimulate cancer growth and jeopardize long-term outcome in patients with Colorectal Liver Metastases (CRLM). We compared survival outcomes of patients with CRLM who underwent major liver resection without PVE. Methods: Data of patients undergoing major liver resection for CRLM between 2006 and 2018 were analyzed retrospectively. Clinical characteristics, Overall Survival (OS), and Disease-Free Survival (DFS) were compared between patients who underwent major liver resection w/wo PVE. Groups with comparable oncologic risk factors (Memorial Sloan Kettering Cancer Center [MSKCC] risk score) were compared. Results: Forty-one of the 53 patients who underwent PVE underwent curative liver resection, and 12 patients did not due to disease progression. Seventy-seven patients underwent major liver resection without preoperative PVE. Subgroup survival analyses based on the MSKCC score (MSCKCC 0-1; 2-3; 4-5) revealed a median DFS for PVE vs. non-PVE of 19 vs. 34 months (P=0.02), 11 vs. 15 (P=ns), and 7 vs. 13 (P=ns). The respective median OS of the groups was 90 vs. 93 months, 36 vs. 46, and 52 vs. 33 (P=ns for all). PVE had no influence on DFS or OS (multivariate COX regression analyses). Conclusion: PVE in patients with inadequate FLR enables safe resection. Multivariable analysis demonstrates that PVE does not result in decreased OS and DFS, thus supporting its long-term oncologic safety.

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Cite the article

Goykhman Y, Sirhan S, Barenboim A, Kori I, Peles-Avraham S, Lahat G, et al. Impact of Portal Vein Embolization on Long-Term Outcome in Patients with Colorectal Liver Metastases. Clin Surg. 2022; 7: 3508..