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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 9/2014

01-09-2014 | Hepatobiliary Tumors

Colorectal Liver Metastases Growth in the Embolized and Non-Embolized Liver After Portal Vein Embolization: Influence of Initial Response to Induction Chemotherapy

Authors: Romain Pommier, MD, Maxime Ronot, MD, PhD, François Cauchy, MD, Sébastien Gaujoux, MD, PhD, David Fuks, MD, PhD, Sandrine Faivre, MD, PhD, Jacques Belghiti, MD, Valérie Vilgrain, MD, PhD

Published in: Annals of Surgical Oncology | Issue 9/2014

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Abstract

Purpose

To compare tumor progression in both embolized and non-embolized liver lobes after portal vein embolization (PVE) in patients with bilobar colorectal liver metastases (CLM), according to the initial response to induction chemotherapy.

Methods

From 2002 to 2012, a total of 42 consecutive patients with bilobar CLM initially treated using induction chemotherapy underwent right PVE to achieve adequate future liver remnant volume. Tumoral and liver parenchyma volumes, as well as their volume variations, were measured on computed tomography before and after PVE in both embolized and non-embolized. Patients were classified as fast (≤6 cycles of induction chemotherapy) and slow (>6 cycles) responders.

Results

Overall, 432 metastases were analyzed in 42 patients. Patients were slow responders in 29 (69 %) cases. Tumoral volume increased in 29 (69 %) cases in the embolized liver (+48 %; p < 0.0001), and in 28 (66 %) cases in the non-embolized liver (+31 %; p < 0.0001). Fast responders had a tumoral volume decrease in both embolized (−4 %) and non-embolized (−9 %) lobes. On the opposite side, slow responders had tumoral volume increase in both embolized (+79 %) and non-embolized (+32 %) lobes. On multivariate analysis, a ‘slow’ response to induction chemotherapy was the only factor associated with tumoral progression in both embolized (p = 0.0012) and non-embolized (p = 0.001) lobes.

Conclusion

Tumor growth after PVE is observed in both embolized and non-embolized liver lobes in most patients but is significantly associated with slow response to induction chemotherapy.
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Metadata
Title
Colorectal Liver Metastases Growth in the Embolized and Non-Embolized Liver After Portal Vein Embolization: Influence of Initial Response to Induction Chemotherapy
Authors
Romain Pommier, MD
Maxime Ronot, MD, PhD
François Cauchy, MD
Sébastien Gaujoux, MD, PhD
David Fuks, MD, PhD
Sandrine Faivre, MD, PhD
Jacques Belghiti, MD
Valérie Vilgrain, MD, PhD
Publication date
01-09-2014
Publisher
Springer US
Published in
Annals of Surgical Oncology / Issue 9/2014
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-014-3700-z

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