PURPOSE: To evaluate the safety and efficacy of sequential transcatheter arterial chemoembolization (TACE) and portal vein embolization (PVE) prior to surgery in hepatocellular carcinoma (HCC) patients and to compare the clinical outcome of the combined procedure with that of a matched group of patients undergoing PVE alone. PATIENTS AND METHODS: From 1997 to 2008, 135 patients with HCC underwent sequential TACE and PVE (n = 71) or PVE alone (n = 64) before right hepatectomy. PVE was performed mean 1.2 months after TACE. In both groups, computed tomography (CT) and liver volumetry were performed before and 2 weeks after PVE to assess degree of left lobe hypertrophy. RESULTS: Baseline patient and tumor characteristics were similar in the two groups. After PVE, the chronological changes of liver enzymes were similar in the two groups. The mean increase in percentage future liver remnant (FLR) volume was higher in the TACE + PVE group (7.3%) than in the PVE-only group (5.8%) (P = 0.035). After surgery, incidence of hepatic failure was higher in the PVE-only group (12%) than in the TACE + PVE (4%) group (P = 0.185). Overall (P = 0.028) and recurrence-free (P = 0.001) survival rates were significantly higher in the TACE + PVE group than in the PVE-only group. CONCLUSION: Sequential TACE and PVE before surgery is a safe and effective method to increase the rate of hypertrophy of the FLR and leads to longer overall and recurrence-free survival in patients with HCC.
PURPOSE: To evaluate the safety and efficacy of sequential transcatheter arterial chemoembolization (TACE) and portal vein embolization (PVE) prior to surgery in hepatocellular carcinoma (HCC) patients and to compare the clinical outcome of the combined procedure with that of a matched group of patients undergoing PVE alone. PATIENTS AND METHODS: From 1997 to 2008, 135 patients with HCC underwent sequential TACE and PVE (n = 71) or PVE alone (n = 64) before right hepatectomy. PVE was performed mean 1.2 months after TACE. In both groups, computed tomography (CT) and liver volumetry were performed before and 2 weeks after PVE to assess degree of left lobe hypertrophy. RESULTS: Baseline patient and tumor characteristics were similar in the two groups. After PVE, the chronological changes of liver enzymes were similar in the two groups. The mean increase in percentage future liver remnant (FLR) volume was higher in the TACE + PVE group (7.3%) than in the PVE-only group (5.8%) (P = 0.035). After surgery, incidence of hepatic failure was higher in the PVE-only group (12%) than in the TACE + PVE (4%) group (P = 0.185). Overall (P = 0.028) and recurrence-free (P = 0.001) survival rates were significantly higher in the TACE + PVE group than in the PVE-only group. CONCLUSION: Sequential TACE and PVE before surgery is a safe and effective method to increase the rate of hypertrophy of the FLR and leads to longer overall and recurrence-free survival in patients with HCC.
Authors: Srinevas K Reddy; Andrew S Barbas; Ryan S Turley; Jennifer L Steel; Allan Tsung; J Wallis Marsh; David A Geller; Bryan M Clary Journal: HPB (Oxford) Date: 2011-07 Impact factor: 3.647
Authors: Vincent S K Yip; Ronnie T P Poon; Kenneth S H Chok; Albert C Y Chan; Wing Chiu Dai; Simon H Y Tsang; See Ching Chan; Chung Mau Lo; Tan To Cheung Journal: World J Surg Date: 2015-11 Impact factor: 3.352
Authors: Fikri Bouazza; Arthur Poncelet; Camilo Alejandro Garcia; Philippe Delatte; Jean Luc Engelhom; Maria Gomez Galdon; Amélie Deleporte; Alain Hendlisz; Bruno Vanderlinden; Patrick Flamen; Vincent Donckier Journal: World J Gastroenterol Date: 2015-08-28 Impact factor: 5.742