title: Right portal vein embolization before right hepatectomy for unilobar colorectal liver metastases reduces the intrahepatic recurrence rate.
abstract: OBJECTIVE
  To assess the effect of portal vein embolization (PVE) on intrahepatic recurrence rate after right hepatectomy for unilobar colorectal liver metastases (CLM).
  
  
  BACKGROUND
  Recent research suggests that CLM could spread retrogradely through the portal vein. PVE may reduce tumor shedding by the occlusion of distal portal branches. However, no study reported the clinical effect of PVE on intrahepatic recurrence after CLM resection.
  
  
  METHODS
  Between 1995 and 2003, 44 patients requiring a right hepatectomy for unilobar CLM were operated in our institution. Right hepatectomy was performed after PVE in 23 patients (group A) and without PVE in 21 (group B). Surgical outcome and site of recurrence were analyzed.
  
  
  RESULTS
  The postoperative mortality was nil. Overall morbidity and transitory liver failure rates were similar in groups A and B (43.4% and 17.3% vs. 33.3% and 14.2%, respectively). The 3- and 5-year overall survival rates did not differ in group A and B patients (61.2% and 43.7% vs. 49.7% and 35.5%, respectively; P = 0.862). The disease-free survival rate was similar in both groups. Thirty patients (68.2%) developed recurrences. Recurrences were intrahepatic in 22 patients (50%) and extrahepatic in 27 (61.3%). Intrahepatic recurrence rate was significantly lower in group A compared with group B (26.0% vs. 76.1% respectively; P < 0.001). PVE, number of CLM, and administration of neoadjuvant chemotherapy were independent prognostic factors for intrahepatic recurrences.
  
  
  CONCLUSIONS
  This study showed that PVE reduces intrahepatic recurrence rate after right hepatectomy for unilobar CLM.
authors.affiliation: Centre de Chirurgie Viscérale et de Transplantation, Hôpital de Hautepierre, Strasbourg, France.
authors.forename: Elie
authors.initials: E
authors.lastname: Oussoultzoglou
authors.forename: Philippe
authors.initials: P
authors.lastname: Bachellier
authors.forename: Edoardo
authors.initials: E
authors.lastname: Rosso
authors.forename: Radu
authors.initials: R
authors.lastname: Scurtu
authors.forename: Ioan
authors.initials: I
authors.lastname: Lucescu
authors.forename: Michel
authors.initials: M
authors.lastname: Greget
authors.forename: Daniel
authors.initials: D
authors.lastname: Jaeck
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D015179:Colorectal Neoplasms / Q000473:pathology*; D018572:Disease-Free Survival; D004621:Embolization, Therapeutic; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011169:Portal Vein; D011300:Preoperative Care
chemical_list: D000970:Antineoplastic Agents