Hypertrophy of the non-embolized liver after chemotherapy

Nafidi, Otmane; Désy, Delphine; Létourneau, Richard; Côté, Jean; Plasse, M.; Vandenbroucke, Franck; Roy, André; Dagenais, Michel; Lapointe, Réal

doi:10.1111/j.1477-2574.2009.00004.x

Cited by 16 publications

(13 citation statements)

References 36 publications

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“…Reasons for failure were the impossibility of cannulating the portal system [17, 34, 42, 46] because of altered portal anatomy caused by the tumor mass or unexpected thrombosis of the portal system due to tumor progression/invasion [17, 25, 46, 47]. The clinical success rate (successful PVE procedure, inducing enough hypertrophy of the FRL to allow resection) however was 96.1 %.…”

Section: Resultsmentioning

confidence: 99%

Portal Vein Embolization Before Liver Resection: A Systematic Review

Lienden

Esschert

Graaf

et al. 2012

Cardiovasc Intervent Radiol

387

337

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PurposeThis is a review of literature on the indications, technique, and outcome of portal vein embolization (PVE).MethodsA systematic literature search on outcome of PVE from 1990 to 2011 was performed in Medline, Cochrane, and Embase databases.ResultsForty-four articles were selected, including 1,791 patients with a mean age of 61 ± 4.1 years. Overall technical success rate was 99.3 %. The mean hypertrophy rate of the FRL after PVE was 37.9 ± 0.1 %. In 70 patients (3.9 %), surgery was not performed because of failure of PVE (clinical success rate 96.1 %). In 51 patients (2.8 %), the hypertrophy response was insufficient to perform liver resection. In the other 17 cases, 12 did not technically succeed (0.7 %) and 7 caused a complication leading to unresectability (0.4 %). In 6.1 %, resection was cancelled because of local tumor progression after PVE. Major complications were seen in 2.5 %, and the mortality rate was 0.1 %. A head-to-head comparison shows a negative effect of liver cirrhosis on hypertrophy response. The use of n-butyl cyanoacrylate seems to have a greater effect on hypertrophy, but the difference with other embolization materials did not reach statistical significance. No difference in regeneration is seen in patients with cholestasis or chemotherapy.ConclusionsPreoperative PVE has a high technical and clinical success rate. Liver cirrhosis has a negative effect on regeneration, but cholestasis and chemotherapy do not seem to have an influence on the hypertrophy response. The use of n-butyl cyanoacrylate may result in a greater hypertrophy response compared with other embolization materials used.

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Section: Resultsmentioning

confidence: 99%

Portal Vein Embolization Before Liver Resection: A Systematic Review

Lienden

Esschert

Graaf

et al. 2012

Cardiovasc Intervent Radiol

387

337

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“…34–36 More recent studies have not found chemotherapy to be associated with poor growth. 11, 27, 37–39 …”

Section: Discussionmentioning

confidence: 99%

Remnant Growth Rate after Portal Vein Embolization Is a Good Early Predictor of Post-Hepatectomy Liver Failure

Leung

Simpson

Araújo

et al. 2014

Journal of the American College of Surgeons

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Background After portal vein embolization (PVE), the future liver remnant (FLR) hypertrophies over several weeks. An early marker that predicts a low risk of post-hepatectomy liver failure may reduce the delay to surgery. Study Design Liver volumes of 153 patients who underwent a major hepatectomy (>3 segments) after PVE for primary or secondary liver malignancy between September 1999 and November 2012 were retrospectively evaluated with computerized volumetry. Pre- and post-PVE FLR volume and functional liver volume (FLV) were measured. Degree of hypertrophy (DH = postFLR/postFLV - preFLR/preFLV) and growth rate (GR = DH / weeks since PVE) were calculated. Postoperative complications and liver failure were correlated with DH, measured GR, and estimated GR (eGR) derived from a formula based on body surface area. Results Eligible patients underwent 93 right hepatectomies, 51 extended right hepatectomies, 4 left hepatectomies, and 5 extended left hepatectomies. Major complications occurred in 44 patients (28.7%) and liver failure in 6 patients (3.9%). Non-parametric regression showed that post-embolization FLR% correlated poorly with liver failure. ROC curves showed that DH and GR were good predictors of liver failure (AUC=0.80, p=0.011, and AUC=0.79, p=0.015) and modest predictors of major complications (AUC=0.66, p=0.002, and AUC=0.61, p=0.032). No patient with GR >2.66%/wk developed liver failure. The predictive value of measured GR was superior to eGR for liver failure (AUC 0.79 vs 0.58, p=0.046). Conclusions Both DH and GR after PVE are strong predictors of post-hepatectomy liver failure. GR may be a better guide for the optimum timing of liver resection than static volumetric measurements. Measured volumetrics correlated with outcomes better than estimated volumetrics.

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“…There are no controlled studies comparing the efficacy of PVE vs. surgical ligation (Table 2) [46,[59][60][61]. Three retrospective studies have shown that the kinetics and degree of hypertrophy of the remnant liver were comparable between the two techniques [23,62,63].…”

Section: Is Portal Vein Ligation As Efficient As Portal Vein Embolizamentioning

confidence: 96%

Portal vein occlusion before major hepatectomy in patients with colorectal liver metastases: Rationale, indications, technical aspects, complications and outcome

Lim

Farges

2012

Journal of Visceral Surgery

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Hypertrophy of the non-embolized liver after chemotherapy

Abstract: In view of our limited experience, we conclude that hypertrophy of the non-embolized liver (FRL) is not altered after FOLFIRI-based NC.

Cited by 16 publications

References 36 publications

Portal Vein Embolization Before Liver Resection: A Systematic Review

Portal Vein Embolization Before Liver Resection: A Systematic Review

Remnant Growth Rate after Portal Vein Embolization Is a Good Early Predictor of Post-Hepatectomy Liver Failure

Portal vein occlusion before major hepatectomy in patients with colorectal liver metastases: Rationale, indications, technical aspects, complications and outcome

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