Liver Regeneration After Portal and Hepatic Vein Embolization Improves Overall Survival Compared with Portal Vein Embolization Alone: Mid-term Survival Analysis of the Multicentre DRAGON 0 Cohort

Overview

Journal Br J Surg

Specialty General Surgery

Date 2024 Apr 25

PMID 38662462

Authors

Remon Korenblik

Jan Heil

Jens Smits

Sinead James

Bram Olij

Wolf O Bechstein

Marc H A Bemelmans

Christoph A Binkert

Stefan Breitenstein

Michael Williams

Olivier Detry

Maxime J L Dewulf

Alexandra Dili

Lukasz F Grochola

Jon Grote

Daniel Heise

Jennifer A Kalil

Peter Metrakos

Ulf P Neumann

Sam G Pappas

Francesca Pennetta

Andreas A Schnitzbauer

Jordan C Tasse

Bjorn Winkens

Steven W M Olde Damink

Christiaan van der Leij

Erik Schadde

Ronald M van Dam

Affiliations

Soon will be listed here.

Abstract

Background: The purpose of this study was to compare 3-year overall survival after simultaneous portal (PVE) and hepatic vein (HVE) embolization versus PVE alone in patients undergoing liver resection for primary and secondary cancers of the liver.

Methods: In this multicentre retrospective study, all DRAGON 0 centres provided 3-year follow-up data for all patients who had PVE/HVE or PVE, and were included in DRAGON 0 between 2016 and 2019. Kaplan-Meier analysis was undertaken to assess 3-year overall and recurrence/progression-free survival. Factors affecting survival were evaluated using univariable and multivariable Cox regression analyses.

Results: In total, 199 patients were included from 7 centres, of whom 39 underwent PVE/HVE and 160 PVE alone. Groups differed in median age (P = 0.008). As reported previously, PVE/HVE resulted in a significantly higher resection rate than PVE alone (92 versus 68%; P = 0.007). Three-year overall survival was significantly higher in the PVE/HVE group (median survival not reached after 36 months versus 20 months after PVE; P = 0.004). Univariable and multivariable analyses identified PVE/HVE as an independent predictor of survival (univariable HR 0.46, 95% c.i. 0.27 to 0.76; P = 0.003).

Conclusion: Overall survival after PVE/HVE is substantially longer than that after PVE alone in patients with primary and secondary liver tumours.

Citing Articles

Propensity Score-Matched Analysis of Liver Venous Deprivation and Portal Vein Embolization Before Planned Hepatectomy in Patients with Extensive Colorectal Liver Metastases and High-Risk Factors for Inadequate Regeneration.

Haddad A, Khavandi M, Lendoire M, Acidi B, Chiang Y, Gupta S Ann Surg Oncol. 2024; 32(3):1752-1761.

PMID: 39633174 DOI: 10.1245/s10434-024-16558-1.

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