title: Right and extended-right hepatectomies for unilobar colorectal metastases: impact of portal vein embolization on long-term outcome and liver recurrence.
abstract: BACKGROUND
  Portal vein embolization (PVE) is an effective procedure to increase the future remnant liver (FRL) before major hepatectomy. A controversial issue is that PVE may stimulate tumor growth and can be associated with poor prognosis after liver resection for colorectal liver metastases (CRLM). The aim of this study was to evaluate the impact of PVE on long-term survival following major hepatectomy for CRLM.
  
  
  METHODS
  Between 1998 and 2010, 100 right and extended-right hepatectomies for unilobar, right-sided CRLM were performed. Of the group, 20 patients underwent preoperative PVE (group A). The control patients (group B; 20 patients) were selected by matching with the group A patients.
  
  
  RESULTS
  It was found that 25 patients (25/40; 62.5%) had developed tumor recurrence. The rate of global recurrence was not significantly different in groups A and B (65% vs 60%, respectively; P = .744). The specific overall intrahepatic recurrence rate was 42.5% (17 of 40 patients) and was not significantly different in groups A and B (45% vs 40%, respectively; P = .749). The 5-year overall and disease-free survival rates were similar in groups A and B (42.9% and 33.6% vs 42.1% and 27.7%, respectively). The 5-year specific liver-disease-free survival was 45.3% in group A and 53.5% in group B (P = .572). On multivariate analysis of all 100 hepatectomies, R1 resection (P = .013) was found to be the only independent predictor of liver-disease-free survival.
  
  
  CONCLUSIONS
  This study showed that PVE did not affect overall survival and specific liver-disease-free survival in patients undergoing right or right-extended hepatectomy for unilobar, right-sided CRLM.
authors.affiliation: Department of Surgery, Hepatobiliary Surgery Unit, Catholic University of the Sacred Heart, School of Medicine, Rome, Italy. francesco.ardito@rm.unicatt.it
authors.forename: Francesco
authors.initials: F
authors.lastname: Ardito
authors.forename: Maria
authors.initials: M
authors.lastname: Vellone
authors.forename: Brunella
authors.initials: B
authors.lastname: Barbaro
authors.forename: Gennaro
authors.initials: G
authors.lastname: Grande
authors.forename: Gennaro
authors.initials: G
authors.lastname: Clemente
authors.forename: Ivo
authors.initials: I
authors.lastname: Giovannini
authors.forename: Bruno
authors.initials: B
authors.lastname: Federico
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Bonomo
authors.forename: Gennaro
authors.initials: G
authors.lastname: Nuzzo
authors.forename: Felice
authors.initials: F
authors.lastname: Giuliante
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D015179:Colorectal Neoplasms; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D004621:Embolization, Therapeutic / Q000009:adverse effects; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000517:prevention & control / Q000556:secondary* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011169:Portal Vein; D011446:Prospective Studies; D016896:Treatment Outcome; D055815:Young Adult