title: Impact of portal vein embolization on long-term survival of patients with primarily unresectable colorectal liver metastases.
abstract: BACKGROUND
  : Portal vein embolization (PVE) increases the resectability of initially unresectable colorectal liver metastases (CLM). This study evaluated long-term survival in patients with CLM who underwent hepatectomy following PVE.
  
  
  METHODS
  : In a retrospective analysis patients treated by PVE before major hepatectomy were compared with those who did not have PVE, and with those who had PVE without resection.
  
  
  RESULTS
  : Of 364 patients who underwent hepatectomy, 67 had PVE beforehand and 297 did not. Those who had PVE more often had more than three liver metastases (68 versus 40.9 per cent; P < 0.001) that were more frequently bilobar (78 versus 55.2 per cent; P < 0.001), and a higher proportion underwent extended hepatectomy (63 versus 18.1 per cent; P < 0.001). Postoperative morbidity rates were 55 and 41.1 per cent respectively (P = 0.035), and overall 3-year survival rates were 44 and 61.0 per cent (P = 0.001). Thirty-two other patients who were treated by PVE but did not undergo resection all died within 3 years.
  
  
  CONCLUSIONS
  : PVE increased the resectability rate of initially unresectable CLM. Among patients who had PVE, long-term survival was better in those who had resection than in those who did not. PVE is of importance in the multimodal treatment of advanced CLM.
authors.affiliation: Centre Hépato-Biliaire, Assistance Publique-Hôpitaux de Paris, Hôpital Paul Brousse, Villejuif, France.
authors.forename: D A
authors.initials: DA
authors.lastname: Wicherts
authors.forename: R J
authors.initials: RJ
authors.lastname: de Haas
authors.forename: P
authors.initials: P
authors.lastname: Andreani
authors.forename: D
authors.initials: D
authors.lastname: Sotirov
authors.forename: C
authors.initials: C
authors.lastname: Salloum
authors.forename: D
authors.initials: D
authors.lastname: Castaing
authors.forename: R
authors.initials: R
authors.lastname: Adam
authors.forename: D
authors.initials: D
authors.lastname: Azoulay
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D015179:Colorectal Neoplasms; D004621:Embolization, Therapeutic / Q000379:methods* / Q000401:mortality; D005260:Female; D006801:Humans; D008026:Ligation; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011169:Portal Vein; D011300:Preoperative Care / Q000379:methods; D016019:Survival Analysis; D016896:Treatment Outcome