IRUS Total

Oncological outcomes of major liver resection following portal vein embolization: a systematic review and a meta-analysis

File Description SizeFormat 
manuscript final J Surg Onc.docxAccepted version94.66 kBMicrosoft WordView/Open
Title: Oncological outcomes of major liver resection following portal vein embolization: a systematic review and a meta-analysis
Authors: Giglio, MC
Giakoustidis, A
Draz, A
Jawad, ZAR
Pai, M
Habib, NA
Jiao, LR
Tait, P
Item Type: Journal Article
Abstract: Background Preoperative portal vein occlusion with either percutaneous portal vein embolization (PVE) or portal vein ligation (PVL) is routinely used to induce liver hypertrophy prior to major liver resection in patients with hepatic malignancy. While this increases the future liver remnant (FLR) and hence the number of patients suitable for resection, recent evidence suggests that induction of liver hypertrophy pre-operatively may promote tumour growth and increase recurrence rates. Aim of the current study is to evaluate the impact of PVE on hepatic recurrence rate and survival in patients with colorectal liver metastases (CRLM). Methods Medline, Embase and Web of Science databases were searched to identify studies assessing the oncological outcomes of patients undergoing major liver resection for CRLM following PVE. Studies comparing patients undergoing one stage liver resection with or without pre-operative PVE were included. The primary outcome was hepatic recurrence (HR). Secondary outcomes were 3- and 5-year overall survival (OS). Results Of the 2131 studies identified, six nonrandomized studies (n=668) met the eligibility criteria comparing outcomes of patients undergoing major liver resection with or without PVE (n=182 vs. n=486 respectively). The median follow-up time ranged from 23.5 to 46 months. There was no significant difference in HR (OR, 0.78; 95% CI, 0.42 to 1.44, p=0.41), 3-year OS (OR, 0.80; 95% CI, 0.56 to 1.14, p=0.22) or 5-year OS (OR, 1.12; 95% CI, 0.40 to 3.11, p=0.82). Conclusion PVE in patients with CRLM has no adverse effect on hepatic recurrence or overall survival following major liver resection.
Issue Date: 8-Jun-2016
Date of Acceptance: 25-Apr-2016
URI: http://hdl.handle.net/10044/1/31671
DOI: https://dx.doi.org/10.1245/s10434-016-5264-6
ISSN: 1534-4681
Publisher: Springer Verlag
Start Page: 3709
End Page: 3717
Journal / Book Title: Annals of Surgical Oncology
Volume: 23
Issue: 11
Copyright Statement: © Springer Verlag 2016. The final publication is available at Springer via http://dx.doi.org/10.1245/s10434-016-5264-6.
Keywords: Oncology & Carcinogenesis
1112 Oncology And Carcinogenesis
Publication Status: Published
Appears in Collections:Department of Surgery and Cancer