title: Prognostic value of the number and volume of liver tumours on portal vein embolization outcomes.
abstract: OBJECTIVE
  Portal vein embolization (PVE) extends the resecability of liver tumours.The issue of PVE is an insufficient growth of the liver parenchyma or a tumour progression in some patients. We evaluated the effect of the volume and the number of liver tumours on the effect of PVE.
  
  
  METHODS
  PVE was performed in 40 patients with liver tumours due to an insufficient future remnant liver volume. The number and the volume of the tumours were evaluated and compared with the final PVE effect.
  
  
  RESULTS
  In patients without any increase of the liver volume after PVE (n=3) the number and the volume of the tumours before PVE were 2.7±2.1 and 2205.1±2432.7mm3, respectively. In patients with sufficient growth of the liver (n=22) it was 3.8±2.2 (NS) and 1164.9±1392.1mm3 (NS), respectively. In patients with tumour progression (n=11) it was 5.6±2.2 and 6971.4±5189.5mm3, respectively (p<0.04 and p<0.005, respectively). Four patients were treated by radiofrequency ablation only due to worsening of their health state. Patients with >4 foci (OR 4.7) and a tumour volume >400mm3 (OR=13.0) had a higher probability of cancer progression or insufficient growth of the liver tissue. Patients with <6 foci and a tumour volume <3100mm3 had an 87.5% probability of a successful liver hypertrophy after PVE.
  
  
  CONCLUSIONS
  The tumour number and volume were crucial for progression of a malignant disease and growth of the liver parenchyma after PVE.
authors.affiliation: Department of Surgery, Charles University, Pilsen, Czech Republic. treska@fnplzen.cz
authors.forename: Vladislav
authors.initials: V
authors.lastname: Treska
authors.forename: Tomas
authors.initials: T
authors.lastname: Skalicky
authors.forename: Vaclav
authors.initials: V
authors.lastname: Liska
authors.forename: Alan
authors.initials: A
authors.lastname: Sutnar
authors.forename: Jiri
authors.initials: J
authors.lastname: Ferda
authors.forename: Hynek
authors.initials: H
authors.lastname: Mirka
authors.forename: Frantisek
authors.initials: F
authors.lastname: Slauf
authors.forename: Boris
authors.initials: B
authors.lastname: Kreuzberg
authors.forename: Jakub
authors.initials: J
authors.lastname: Fichtl
mesh_terms: D000328:Adult; D000368:Aged; D054893:Cone-Beam Computed Tomography; D018450:Disease Progression; D004621:Embolization, Therapeutic / Q000009:adverse effects; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging / Q000556:secondary / Q000601:surgery / Q000628:therapy*; D008115:Liver Regeneration; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000009:adverse effects; D009378:Neoplasms, Multiple Primary / Q000098:blood supply / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D016017:Odds Ratio; D011169:Portal Vein; D011237:Predictive Value of Tests; D012372:ROC Curve; D013997:Time Factors; D016896:Treatment Outcome; D047368:Tumor Burden