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01-05-2011 | Hepatobiliary Tumors

Sequential Transcatheter Arterial Chemoembolization and Portal Vein Embolization versus Portal Vein Embolization Only before Major Hepatectomy for Patients with Hepatocellular Carcinoma

Authors: Hyunkyung Yoo, MD, Jin Hyoung Kim, MD, Gi-Young Ko, MD, Kyoung Won Kim, MD, Dong Il Gwon, MD, Sung-Gyu Lee, MD, Shin Hwang, MD

Published in: Annals of Surgical Oncology | Issue 5/2011

Abstract

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.

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Title: Sequential Transcatheter Arterial Chemoembolization and Portal Vein Embolization versus Portal Vein Embolization Only before Major Hepatectomy for Patients with Hepatocellular Carcinoma
Authors: Hyunkyung Yoo, MD
Jin Hyoung Kim, MD
Gi-Young Ko, MD
Kyoung Won Kim, MD
Dong Il Gwon, MD
Sung-Gyu Lee, MD
Shin Hwang, MD
Publication date: 01-05-2011
Publisher: Springer-Verlag
Published in: Annals of Surgical Oncology / Issue 5/2011
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-010-1423-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Sequential Transcatheter Arterial Chemoembolization and Portal Vein Embolization versus Portal Vein Embolization Only before Major Hepatectomy for Patients with Hepatocellular Carcinoma

Abstract

Purpose

Patients and Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Patients and Methods

Results

Conclusion

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