Extended right-sided liver resection for colorectal liver metastases--impact of percutaneous portal venous embolisation.
OBJECTIVE
To compare the outcome after extended right liver lobe resection (ERL) for patients with liver metastases from colorectal cancer with preceding portal vein embolisation (PVE) with a non-PVE-group.


METHODS
Nineteen patients underwent ERL (resection of segment 4-8) for colorectal liver metastases after PVE. They were compared with 21 patients that underwent an ERL without embolisation. A comparison was made with 84 patients undergoing right lobe liver resection during the same time period. Survival, post-operative morbidity and mortality were recorded and the volume of the future remnant liver (FRL) was measured with CT.


RESULTS
There were major complications in 1/19 patients in the PVE-group and in 6/21 in the non-PVE-group (p=0.04). No post-operative deaths were observed in the PVE-group, compared to three deaths in the non-PVE-group (p=0.09). The median survival in the PVE-group was 32 months, which did not differ from the non-PVE-group. In 21% of the patients that underwent PVE, progression occurred during the time between embolisation and surgery. There was no difference in survival for patients that underwent PVE followed by ERL, compared to patients that underwent standard right lobe liver resection.


CONCLUSIONS
The survival of patients after ERL is comparable with patients that undergo standard right lobe resection and have less liver tumour.
Lindnér
P
P
Department of Surgery and Radiology, Sahlgrenska University Hospital, S-413 45 Goteborg, Sweden. per.lindner@surgery.gu.se
Cahlin
C
C
Friman
S
S
Hafstrom
L
L
Klingenstierna
H
H
Lonn
L
L
Olausson
M
M
Rizell
M
M
D015179:Colorectal Neoplasms / Q000473:pathology*; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011169:Portal Vein; D011300:Preoperative Care; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome