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.

Humans Portal Vein Male Female Liver Neoplasms / therapy Retrospective Studies Embolization, Therapeutic / methods Middle Aged Liver Regeneration / physiology Aged Hepatic Veins Hepatectomy / methods Survival Rate Survival Analysis Adult

Journal

The British journal of surgery

ISSN: 1365-2168

Titre abrégé: Br J Surg

Pays: England

ID NLM: 0372553

Informations de publication

Date de publication:
03 Apr 2024

Historique:

received: 08 12 2023

revised: 04 03 2024

accepted: 06 03 2024

medline: 25 4 2024

pubmed: 25 4 2024

entrez: 25 4 2024

Statut: ppublish

Résumé

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. 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. 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). Overall survival after PVE/HVE is substantially longer than that after PVE alone in patients with primary and secondary liver tumours.

Sections du résumé

BACKGROUND BACKGROUND

METHODS 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 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 CONCLUSIONS

Overall survival after PVE/HVE is substantially longer than that after PVE alone in patients with primary and secondary liver tumours.

Identifiants

DOI: 10.1093/bjs/znae087 PMID: 38662462

pubmed: 38662462

pii: 7658259

doi: 10.1093/bjs/znae087

pii:

doi:

Types de publication

Journal Article Multicenter Study Comparative Study

Langues

eng

Sous-ensembles de citation

Subventions

Organisme : DRAGON trials

Investigateurs

L Aldrighetti (L)

L van Baardewijk (L)

L Barbier (L)

C Binkert (C)

B Björnsson (B)

Cugat Andorrà E (CA)

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 de Boo (D)

D Breen (D)

S Breitenstein (S)

P Bruners (P)

A Cappelli (A)

U Carling (U)

M Casellas I Robert (MC)

B Chan (B)

F De Cobelli (F)

C Cha (C)

J Choi (J)

M Crawford (M)

D Croagh (D)

R M van Dam (RM)

F Deprez (F)

O Detry (O)

M Dewulf (M)

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 Fouraschen (S)

Å A Fretland (ÅA)

Y Fundora (Y)

A Gelabert (A)

L Gerard (L)

P Gobardhan (P)

F Gómez (F)

F Guiliante (F)

T Gruenberger (T)

L F Grochola (LF)

D Grünhagen (D)

J Guitart Giménez (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 Garcia Borobia (FG)

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 Leclercq (W)

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)

N Montanari (N)

J Sampere Moragues (JS)

J Navinés López (J)

U P Neumann (UP)

J Nguyen (J)

P Peddu (P)

J Primrose (J)

S W M Olde Damink (SWMO)

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 Stavrou (G)

R Sutcliffe (R)

I Tancredi (I)

J C Tasse (JC)

U Teichgräber (U)

V Udupa (V)

D A Valenti (DA)

D Vass (D)

T Vogl (T)

X Wang (X)

S White (S)

J F De Wispelaere (JF)

W Wohlgemuth (W)

D Yu (D)

I J A J Zijlstra (IJAJ)