Background: Two-staged hepatectomy (TSH) with portal (PVE) or dual vein embolization (DVE) gained acceptance in liver surgery. The current study assesses the incidence and causes of failure to progress to completion hepatectomy following PVE/DVE and its influence on overall survival (OS).
Methods: This is a longitudinal observational study of patients who underwent PVE or DVE between April 2010-December 2023. Future liver remnant (FLR) volume was measured at least four weeks later. Restaging and resectability was assessed on imaging performed within 6-8 weeks of planned completion surgery.
Results: 130 patients underwent PVE (90) or DVE (40) during the study period. Of these, 73 (56 %) patients proceeded to definitive resection. Reasons for failure to progress to completion surgery were: disease progression (79 %), declined fitness for surgery (3.5 %) and inadequate FLR volume (14 %). Synchronous disease is a poor prognostic factor for achieving completion hepatectomy CRLM patients (p = 0.009). The median OS with and without completion hepatectomy was 38 months vs. 13 months in CRLM patients (p=<.001) and 31 months vs. 26 months in pCCA groups respectively (p = 0.471).
Conclusion: A significant percentage of patients did not progress to completion hepatectomy due to disease progression. Patient selection and efficient pathways are essential to improve resection rates following these resource-intensive procedures.
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http://dx.doi.org/10.1016/j.hpb.2024.11.011 | DOI Listing |
BMC Cancer
December 2024
Department of Surgery, Tokushima University, 3-18-15 Kuramoto-Cho, Tokushima, 770-8503, Japan.
Background: Colorectal cancer (CRC) has increasingly come into worldwide cancer and almost half of patients have liver metastasis (CRLM) during the progression. Therefore, treatment of colorectal cancer liver metastasis (CRLM) is important to improve the prognosis of CRC patients. Histopathological growth patterns (HGPs) of CRLM have emerged as a reliable prognostic marker.
View Article and Find Full Text PDFHPB (Oxford)
December 2024
Department of HPB Surgery and Liver Transplantation, Queen Elizabeth Hospital, Birmingham, UK; Institute of Immunology and Immunotherapy, University of Birmingham, UK. Electronic address:
Background: Two-staged hepatectomy (TSH) with portal (PVE) or dual vein embolization (DVE) gained acceptance in liver surgery. The current study assesses the incidence and causes of failure to progress to completion hepatectomy following PVE/DVE and its influence on overall survival (OS).
Methods: This is a longitudinal observational study of patients who underwent PVE or DVE between April 2010-December 2023.
Hepatobiliary Surg Nutr
December 2024
Hepatobiliary and Pancreatic Surgery Department, CHU de Bordeaux, Pessac, France.
Background: Post-hepatectomy liver failure (PHLF) is the first cause of death after major hepatectomy, and future liver remnant (FLR) volume is the main factor predicting PHLF. Liver venous deprivation (LVD) via portal and hepatic vein embolization has been suggested to induce a better hypertrophy of the FLR than portal vein embolization. The aim of this retrospective multicentric study was to assess safety, feasibility and efficacity of LVD in a French national multicentric register.
View Article and Find Full Text PDFHepatobiliary Surg Nutr
December 2024
Department of General, Visceral, and Oncological Surgery, Klinikum Saarbrücken, Saarbrücken, Germany.
Hepatobiliary Surg Nutr
December 2024
Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
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