[Portal vein embolization before surgery for liver tumours]

Area of Science:

• Interventional Radiology
• Hepatobiliary Surgery
• Oncology

Background:

• Radical resection is the primary cure for malignant liver tumors.
• Insufficient liver remnant volume is a key surgical contraindication.
• Portal vein embolization (PVE) can induce contralateral liver lobe hypertrophy.

Purpose of the Study:

• To evaluate the efficacy of PVE in increasing liver remnant volume.
• To determine if PVE expands surgical eligibility for liver resection.
• To assess the oncological outcomes following PVE and resection.

Main Methods:

• 18 patients (aged 35-71) underwent percutaneous transhepatic PVE between 2002-2006.
• Interventional radiological techniques were employed for embolization.
• Patient eligibility for resection and outcomes were monitored.

Main Results:

• Median liver remnant volume increased by 45% (range 9-100%) in all patients.
• Liver resection was feasible in 10 patients post-PVE.
• Seven patients were ineligible for resection due to tumor progression; one due to chemotherapy side effects.
• Four-year survival for colorectal cancer metastases was 58%.

Conclusions:

• PVE substantially increases liver volume, expanding the pool of patients eligible for liver surgery.
• The technique allows selected patients to achieve long-term survival comparable to those initially operable.
• Advanced imaging is crucial for identifying patients who will benefit from PVE.