Liver regeneration after portal and hepatic vein embolization improves overall survival compared with portal vein embolization alone: mid-term survival analysis of the multicentre DRAGON 0 cohort
Author:
Korenblik Remon12ORCID, Heil Jan34, Smits Jens12, James Sinead12, Olij Bram12, Bechstein Wolf O4, Bemelmans Marc H A25, Binkert Christoph A6, Breitenstein Stefan7, Williams Michael8, Detry Olivier9ORCID, Dewulf Maxime J L25, Dili Alexandra10, Grochola Lukasz F7ORCID, Grote Jon5, Heise Daniel511, Kalil Jennifer A12, Metrakos Peter12, Neumann Ulf P2511, Pappas Sam G8, Pennetta Francesca12, Schnitzbauer Andreas A4, Tasse Jordan C13, Winkens Bjorn14, Olde Damink Steven W M2515, van der Leij Christiaan116, Schadde Erik381718, van Dam Ronald M125ORCID, , Aldrighetti L, van Baardewijk L, Barbier L, Binkert C, Björnsson B, E Cugat Andorrà, Arslan B, Baclija I, Bemelmans M H A, Bent C, de Boer M T, Bokkers R P H, de Boo D, Breen D, Breitenstein S, Bruners P, Cappelli A, Carling U, i Robert M Casellas, Chan B, De Cobelli F, Cha C, Choi J, Crawford M, Croagh D, van Dam R M, Deprez F, Detry O, Dewulf M, Díaz-Nieto R, Dili A, Erdmann J I, Font J Codina, Davis R, Delle M, Fernando R, Fisher O, Fouraschen S, Fretland Å A, Fundora Y, Gelabert A, Gerard L, Gobardhan P, Gómez F, Guiliante F, Gruenberger T, Grochola L F, Grünhagen D, Guitart Giménez J, Hagendoorn J, Heil J, Heise D, Herrero E, Hess G, Hilal M Abu, Hoffmann M, Iezzi R, Imani F, Inmutto N, James S, Borobia F Garcia, Jovine E, Kalil J, Kingham P, Kollmar O, Kleeff J, van der Leij C, Lopez-Ben S, Macdonald A, Meijerink M, Korenblik R, Lapisatepun W, Leclercq W, Lindsay R, Lucidi V, Madoff D C, Martel G, Mehrzad H, Menon K, Metrakos P, Modi S, Montanari N, Moragues J Sampere, Navinés López J, Neumann U P, Nguyen J, Peddu P, Primrose J, Damink S W M Olde, Qu X, Raptis D A, Ratti F, Ryan S, Ridouani F, Rinkes I H M Borel, Rogan C, Ronellenfitsch U, Serenari M, Salik A, Sallemi C, Sandström P, Martin E Santos, Sarría L, Schadde E, Serrablo A, Settmacher U, Smits J, Smits M L J, Snitzbauer A, Soonawalla Z, Sparrelid E, Spuentrup E, Stavrou G, Sutcliffe R, Tancredi I, Tasse J C, Teichgräber U, Udupa V, Valenti D A, Vass D, Vogl T, Wang X, White S, De Wispelaere J F, Wohlgemuth W, YU D, Zijlstra I J A J
Affiliation:
1. GROW—School for Oncology and Reproduction, Maastricht University , Maastricht , the Netherlands 2. Department of Surgery, Maastricht University Medical Centre , Maastricht , the Netherlands 3. Institute of Physiology, University of Zurich , Zurich , Switzerland 4. Department of General, Visceral and Transplant Surgery, University Hospital Frankfurt, Goethe-University Frankfurt , Frankfurt , Germany 5. Department of General, Visceral and Transplant Surgery, University Hospital Aachen , Aachen , Germany 6. Department of Radiology, Cantonal Hospital Winterthur , Winterthur , Switzerland 7. Department of General and Visceral Surgery, Cantonal Hospital Winterthur , Winterthur , Switzerland 8. Department of Surgery, Rush University Medical Center Chicago , Chicago, Illinois , USA 9. Department of Abdominal Surgery and Transplantation, University of Liege, CHU Liege , Liege , Belgium 10. Department of Abdominal Surgery, CHU-UC Louvain-Namur , Yvoir , Belgium 11. Department of General, Visceral and Transplant Surgery, University Hospital Essen , Essen , Germany 12. Department of Surgery, Section of Hepato-pancreatico-biliary Surgery, McGill University Health Centre , Montreal, Québec , Canada 13. Department of Radiology, Rush University Medical Center Chicago , Chicago, Illinois , USA 14. Department of Methodology and Statistics, Care and Public Health Research Institute (CAPHRI), Maastricht University , Maastricht , the Netherlands 15. NUTRIM—School of Nutrition and Translational Research in Metabolism, Maastricht University , Maastricht , the Netherlands 16. Department of Radiology, Maastricht University Medical Centre , Maastricht , the Netherlands 17. Surgical Centre, Hirslanden Clinic Zurich , Zurich , Switzerland 18. Switzerland Surgical Centre, Hirslanden Clinic St Anna Luzern , Luzern , Switzerland
Abstract
Abstract
Background
The purpose of this study was to compare 3-year overall survival after simultaneous portal (PVE) and hepatic vein (HVE) embolization versus PVE alone in patients undergoing liver resection for primary and secondary cancers of the liver.
Methods
In this multicentre retrospective study, all DRAGON 0 centres provided 3-year follow-up data for all patients who had PVE/HVE or PVE, and were included in DRAGON 0 between 2016 and 2019. Kaplan–Meier analysis was undertaken to assess 3-year overall and recurrence/progression-free survival. Factors affecting survival were evaluated using univariable and multivariable Cox regression analyses.
Results
In total, 199 patients were included from 7 centres, of whom 39 underwent PVE/HVE and 160 PVE alone. Groups differed in median age (P = 0.008). As reported previously, PVE/HVE resulted in a significantly higher resection rate than PVE alone (92 versus 68%; P = 0.007). Three-year overall survival was significantly higher in the PVE/HVE group (median survival not reached after 36 months versus 20 months after PVE; P = 0.004). Univariable and multivariable analyses identified PVE/HVE as an independent predictor of survival (univariable HR 0.46, 95% c.i. 0.27 to 0.76; P = 0.003).
Conclusion
Overall survival after PVE/HVE is substantially longer than that after PVE alone in patients with primary and secondary liver tumours.
Publisher
Oxford University Press (OUP)
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