Resectability of bilobar liver tumours after simultaneous portal and hepatic vein embolization versus portal vein embolization alone: meta-analysis.
Journal
BJS open
ISSN: 2474-9842
Titre abrégé: BJS Open
Pays: England
ID NLM: 101722685
Informations de publication
Date de publication:
02 11 2022
02 11 2022
Historique:
received:
29
07
2022
revised:
09
09
2022
accepted:
05
10
2022
entrez:
28
11
2022
pubmed:
29
11
2022
medline:
30
11
2022
Statut:
ppublish
Résumé
Many patients with bi-lobar liver tumours are not eligible for liver resection due to an insufficient future liver remnant (FLR). To reduce the risk of posthepatectomy liver failure and the primary cause of death, regenerative procedures intent to increase the FLR before surgery. The aim of this systematic review is to provide an overview of the available literature and outcomes on the effectiveness of simultaneous portal and hepatic vein embolization (PVE/HVE) versus portal vein embolization (PVE) alone. A systematic literature search was conducted in PubMed, Web of Science, and Embase up to September 2022. The primary outcome was resectability and the secondary outcome was the FLR volume increase. Eight studies comparing PVE/HVE with PVE and six retrospective PVE/HVE case series were included. Pooled resectability within the comparative studies was 75 per cent in the PVE group (n = 252) versus 87 per cent in the PVE/HVE group (n = 166, OR 1.92 (95% c.i., 1.13-3.25)) favouring PVE/HVE (P = 0.015). After PVE, FLR hypertrophy between 12 per cent and 48 per cent (after a median of 21-30 days) was observed, whereas growth between 36 per cent and 67 per cent was reported after PVE/HVE (after a median of 17-31 days). In the comparative studies, 90-day primary cause of death was similar between groups (2.5 per cent after PVE versus 2.2 per cent after PVE/HVE), but a higher 90-day primary cause of death was reported in single-arm PVE/HVE cohort studies (6.9 per cent, 12 of 175 patients). Based on moderate/weak evidence, PVE/HVE seems to increase resectability of bi-lobar liver tumours with a comparable safety profile. Additionally, PVE/HVE resulted in faster and more pronounced hypertrophy compared with PVE alone.
Sections du résumé
BACKGROUND
Many patients with bi-lobar liver tumours are not eligible for liver resection due to an insufficient future liver remnant (FLR). To reduce the risk of posthepatectomy liver failure and the primary cause of death, regenerative procedures intent to increase the FLR before surgery. The aim of this systematic review is to provide an overview of the available literature and outcomes on the effectiveness of simultaneous portal and hepatic vein embolization (PVE/HVE) versus portal vein embolization (PVE) alone.
METHODS
A systematic literature search was conducted in PubMed, Web of Science, and Embase up to September 2022. The primary outcome was resectability and the secondary outcome was the FLR volume increase.
RESULTS
Eight studies comparing PVE/HVE with PVE and six retrospective PVE/HVE case series were included. Pooled resectability within the comparative studies was 75 per cent in the PVE group (n = 252) versus 87 per cent in the PVE/HVE group (n = 166, OR 1.92 (95% c.i., 1.13-3.25)) favouring PVE/HVE (P = 0.015). After PVE, FLR hypertrophy between 12 per cent and 48 per cent (after a median of 21-30 days) was observed, whereas growth between 36 per cent and 67 per cent was reported after PVE/HVE (after a median of 17-31 days). In the comparative studies, 90-day primary cause of death was similar between groups (2.5 per cent after PVE versus 2.2 per cent after PVE/HVE), but a higher 90-day primary cause of death was reported in single-arm PVE/HVE cohort studies (6.9 per cent, 12 of 175 patients).
CONCLUSION
Based on moderate/weak evidence, PVE/HVE seems to increase resectability of bi-lobar liver tumours with a comparable safety profile. Additionally, PVE/HVE resulted in faster and more pronounced hypertrophy compared with PVE alone.
Identifiants
pubmed: 36437731
pii: 6844022
doi: 10.1093/bjsopen/zrac141
pmc: PMC9702575
pii:
doi:
Types de publication
Systematic Review
Meta-Analysis
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : Abbott Laboratories
Organisme : Maastricht University
Investigateurs
L A Aldrighetti
(LA)
L J van Baardewijk
(LJ)
L Barbier
(L)
C A Binkert
(CA)
K Billingsley
(K)
B Björnsson
(B)
E Cugat Andorrà
(EC)
B Arslan
(B)
I Baclija
(I)
M H A Bemelmans
(MHA)
C Bent
(C)
M T de Boer
(MT)
R P H Bokkers
(RPH)
D W de Boo
(DW)
D Breen
(D)
S Breitenstein
(S)
P Bruners
(P)
A Cappelli
(A)
U Carling
(U)
M Casellas I Robert
(MCI)
B Chan
(B)
F De Cobelli
(F)
J Choi
(J)
M Crawford
(M)
D Croagh
(D)
R M van Dam
(RM)
F Deprez
(F)
O Detry
(O)
M J L Dewulf
(MJL)
R Díaz-Nieto
(R)
A Dili
(A)
J I Erdmann
(JI)
J Codina Font
(JC)
R Davis
(R)
M Delle
(M)
R Fernando
(R)
O Fisher
(O)
S M G Fouraschen
(SMG)
Å A Fretland
(ÅA)
Y Fundora
(Y)
A Gelabert
(A)
L Gerard
(L)
P Gobardhan
(P)
F Gómez
(F)
F Guiliante
(F)
T Grünberger
(T)
L F Grochola
(LF)
D J Grünhagen
(DJ)
J Guitart
(J)
J Hagendoorn
(J)
J Heil
(J)
D Heise
(D)
E Herrero
(E)
G Hess
(G)
M Abu Hilal
(MA)
M Hoffmann
(M)
R Iezzi
(R)
F Imani
(F)
N Inmutto
(N)
S James
(S)
F J Garcia Borobia
(FJG)
E Jovine
(E)
J Kalil
(J)
P Kingham
(P)
O Kollmar
(O)
J Kleeff
(J)
C van der Leij
(C)
S Lopez-Ben
(S)
A Macdonald
(A)
M Meijerink
(M)
R Korenblik
(R)
W Lapisatepun
(W)
W K G Leclercq
(WKG)
R Lindsay
(R)
V Lucidi
(V)
D C Madoff
(DC)
G Martel
(G)
H Mehrzad
(H)
K Menon
(K)
P Metrakos
(P)
S Modi
(S)
A Moelker
(A)
N Montanari
(N)
J Sampere Moragues
(JS)
J Navinés-López
(J)
U P Neumann
(UP)
J Nguyen
(J)
P Peddu
(P)
J N Primrose
(JN)
S W M Olde Damink
(SWM)
X Qu
(X)
D A Raptis
(DA)
F Ratti
(F)
S Ryan
(S)
F Ridouani
(F)
I H M Borel Rinkes
(IHMB)
C Rogan
(C)
U Ronellenfitsch
(U)
M Serenari
(M)
A Salik
(A)
C Sallemi
(C)
P Sandström
(P)
E Santos Martin
(ES)
L Sarría
(L)
E Schadde
(E)
A Serrablo
(A)
U Settmacher
(U)
J Smits
(J)
M L J Smits
(MLJ)
A Snitzbauer
(A)
Z Soonawalla
(Z)
E Sparrelid
(E)
E Spuentrup
(E)
G A Stavrou
(GA)
R Sutcliffe
(R)
I Tancredi
(I)
J C Tasse
(JC)
U Teichgräber
(U)
V Udupa
(V)
D A Valenti
(DA)
D Vass
(D)
T J Vogl
(TJ)
X Wang
(X)
S White
(S)
J F De Wispelaere
(JF)
W A Wohlgemuth
(WA)
D Yu
(D)
Ij A J Zijlstra
(IAJ)
Informations de copyright
© The Author(s) 2022. Published by Oxford University Press on behalf of BJS Society Ltd.
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