학술논문
Liver regeneration after portal and hepatic vein embolization improves overall survival compared with portal vein embolization alone: mid-term survival analysis of the multicentre DRAGON 0 cohort.
Document Type
Article
Author
Korenblik, Remon; Heil, Jan; Smits, Jens; James, Sinead; Olij, Bram; Bechstein, Wolf O; Bemelmans, Marc H A; Binkert, Christoph A; Breitenstein, Stefan; Williams, Michael; Detry, Olivier; Dewulf, Maxime J L; Dili, Alexandra; Grochola, Lukasz F; Grote, Jon; Heise, Daniel; Kalil, Jennifer A; Metrakos, Peter; Neumann, Ulf P; Pappas, Sam G
Source
Subject
*HEPATIC veins
*OVERALL survival
*PORTAL vein
*LIVER regeneration
*SURVIVAL analysis (Biometry)
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Language
ISSN
0007-1323
Abstract
Background: The purpose of this study was to compare 3-year overall survival after simultaneous portal (PVE) and hepatic vein (HVE) embolization versus PVE alone in patients undergoing liver resection for primary and secondary cancers of the liver. Methods: In this multicentre retrospective study, all DRAGON 0 centres provided 3-year follow-up data for all patients who had PVE/HVE or PVE, and were included in DRAGON 0 between 2016 and 2019. Kaplan–Meier analysis was undertaken to assess 3-year overall and recurrence/progression-free survival. Factors affecting survival were evaluated using univariable and multivariable Cox regression analyses. Results: In total, 199 patients were included from 7 centres, of whom 39 underwent PVE/HVE and 160 PVE alone. Groups differed in median age (P = 0.008). As reported previously, PVE/HVE resulted in a significantly higher resection rate than PVE alone (92 versus 68%; P = 0.007). Three-year overall survival was significantly higher in the PVE/HVE group (median survival not reached after 36 months versus 20 months after PVE; P = 0.004). Univariable and multivariable analyses identified PVE/HVE as an independent predictor of survival (univariable HR 0.46, 95% c.i. 0.27 to 0.76; P = 0.003). Conclusion: Overall survival after PVE/HVE is substantially longer than that after PVE alone in patients with primary and secondary liver tumours. The multicentre international retrospective DRAGON 0 study showed that simultaneous portal (PVE) and hepatic vein (HVE) embolization in patients with cancer in the liver increases the future liver remnant hypertrophy, kinetic growth rate, and resection rate compared with PVE alone. Mid-term oncological follow-up showed that median 3-year overall survival was significantly increased in the PVE/HVE group. [ABSTRACT FROM AUTHOR]