title: Colorectal liver metastases growth in the embolized and non-embolized liver after portal vein embolization: influence of initial response to induction chemotherapy.
abstract: OBJECTIVE
  To compare tumor progression in both embolized and non-embolized liver lobes after portal vein embolization (PVE) in patients with bilobar colorectal liver metastases (CLM), according to the initial response to induction chemotherapy.
  
  
  METHODS
  From 2002 to 2012, a total of 42 consecutive patients with bilobar CLM initially treated using induction chemotherapy underwent right PVE to achieve adequate future liver remnant volume. Tumoral and liver parenchyma volumes, as well as their volume variations, were measured on computed tomography before and after PVE in both embolized and non-embolized. Patients were classified as fast (≤6 cycles of induction chemotherapy) and slow (>6 cycles) responders.
  
  
  RESULTS
  Overall, 432 metastases were analyzed in 42 patients. Patients were slow responders in 29 (69 %) cases. Tumoral volume increased in 29 (69 %) cases in the embolized liver (+48 %; p < 0.0001), and in 28 (66 %) cases in the non-embolized liver (+31 %; p < 0.0001). Fast responders had a tumoral volume decrease in both embolized (-4 %) and non-embolized (-9 %) lobes. On the opposite side, slow responders had tumoral volume increase in both embolized (+79 %) and non-embolized (+32 %) lobes. On multivariate analysis, a 'slow' response to induction chemotherapy was the only factor associated with tumoral progression in both embolized (p = 0.0012) and non-embolized (p = 0.001) lobes.
  
  
  CONCLUSIONS
  Tumor growth after PVE is observed in both embolized and non-embolized liver lobes in most patients but is significantly associated with slow response to induction chemotherapy.
authors.affiliation: Department of Radiology, Beaujon Hospital (AP-HP), Beaujon University Hospitals Paris Nord Val de Seine, Clichy, Hauts-de-Seine, France.
authors.forename: Romain
authors.initials: R
authors.lastname: Pommier
authors.forename: Maxime
authors.initials: M
authors.lastname: Ronot
authors.forename: François
authors.initials: F
authors.lastname: Cauchy
authors.forename: Sébastien
authors.initials: S
authors.lastname: Gaujoux
authors.forename: David
authors.initials: D
authors.lastname: Fuks
authors.forename: Sandrine
authors.initials: S
authors.lastname: Faivre
authors.forename: Jacques
authors.initials: J
authors.lastname: Belghiti
authors.forename: Valérie
authors.initials: V
authors.lastname: Vilgrain
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D003131:Combined Modality Therapy; D004621:Embolization, Therapeutic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D060828:Induction Chemotherapy; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011169:Portal Vein; D011379:Prognosis; D015996:Survival Rate