Comparison of Complications in Patients with Ductal Cholangiocarcinoma (CCC) and Patients with Colorectal Liver Metastases (CRLMs) After Portal Vein Embolization (PVE): A Matched Cohort Study.

Cholangiocarcinoma Colorectal carcinoma Complication Portal vein embolization

Journal

Cardiovascular and interventional radiology
ISSN: 1432-086X
Titre abrégé: Cardiovasc Intervent Radiol
Pays: United States
ID NLM: 8003538

Informations de publication

Date de publication:
15 Jul 2024
Historique:
received: 25 12 2023
accepted: 02 07 2024
medline: 16 7 2024
pubmed: 16 7 2024
entrez: 15 7 2024
Statut: aheadofprint

Résumé

To compare complications in patients with cholangiocarcinoma (CCC) and patients with colorectal liver metastases (CRLMs) after portal vein embolization (PVE) and to identify possible predictive factors. Retrospective analysis of consecutive patients, who underwent PVE between July 2011 and March 2020. The study groups were matched for sex and age. Multivariable analysis was performed for the endpoints of complications categorized according for their respective effect on surgical treatment: "Minor" complications had no effect on subsequent surgical treatment, while "intermediate" and "severe" complications delayed or prevented surgery. A total of 160 patients with either CCC (n = 80) or CRLMs (n = 80) were included: 34/160 experienced complications: 27 (CCC: 21; CRLMs: 6) "minor", 4 (CCC: 3; CRLMs: 1) "intermediate", and 3 (CCC: 2; CRLMs: 1) "severe" complications respectively (p = .01). Patients with CCC received a biliary drainage 5 days on average before PVE. Baseline bilirubin levels were 1.1 mg/dl in CCC patients and 0.55 mg/dl in CRLMs patients (p < .01). Postinterventional infections were more common in CCC patients. The preintervention future liver remnant volume (odds ratio (OR) 0.93; 95% confidence interval (CI) 0.88-0.99; p = .02), body mass index (OR 1.19; 95% CI 1.04-1.36; p = .01), age (OR 0,91; 95% CI 0.84-0.99; p = .01), chemotherapy before PVE (OR 0.03; 95% CI 0.01-0.23; p < .01) and severe liver steatosis (OR 29.52; 95% CI 1.87-467,13; p = .02) were the only significant predictive factors for the occurrence of (minor) complications. PVE can be performed in CCC patients with prior biliary drainage, with similar procedural safety as in patients with CRLMs.

Identifiants

pubmed: 39009843
doi: 10.1007/s00270-024-03810-0
pii: 10.1007/s00270-024-03810-0
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2024. Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE).

Références

Cervantes A, et al. Metastatic colorectal cancer: ESMO clinical practice guideline for diagnosis, treatment and follow-up☆. Ann Oncol. 2023;34(1):10–32. https://doi.org/10.1016/j.annonc.2022.10.003 .
doi: 10.1016/j.annonc.2022.10.003 pubmed: 36307056
Vogel A, et al. Biliary tract cancer: ESMO clinical practice guideline for diagnosis, treatment and follow-up☆. Ann Oncol. 2023;34(2):127–40. https://doi.org/10.1016/j.annonc.2022.10.506 .
doi: 10.1016/j.annonc.2022.10.506 pubmed: 36372281
Primavesi F, et al. E-AHPBA–ESSO–ESSR Innsbruck consensus guidelines for preoperative liver function assessment before hepatectomy. Br J Surg. 2023;110(10):1331–47. https://doi.org/10.1093/bjs/znad233 .
doi: 10.1093/bjs/znad233 pubmed: 37572099 pmcid: 10480040
Madoff DC, et al. Transhepatic portal vein embolization: anatomy, indications, and technical considerations. Radiographics. 2002;22(5):1063–76. https://doi.org/10.1148/radiographics.22.5.g02se161063 .
doi: 10.1148/radiographics.22.5.g02se161063 pubmed: 12235336
van Lienden KP, et al. Portal vein embolization before liver resection: a systematic review. Cardiovasc Intervent Radiol. 2013;36(1):25–34. https://doi.org/10.1007/s00270-012-0440-y .
doi: 10.1007/s00270-012-0440-y pubmed: 22806245
Heil J, et al. Preoperative portal vein or portal and hepatic vein embolization: DRAGON collaborative group analysis. Br J Surg. 2021;108(7):834–42. https://doi.org/10.1093/bjs/znaa149 .
doi: 10.1093/bjs/znaa149 pubmed: 33661306
Charalel RA, et al. Systematic reviews and meta-analyses of portal vein embolization, associated liver partition and portal vein ligation, and radiation lobectomy outcomes in hepatocellular carcinoma patients. Curr Oncol Rep. 2021;23(11):135. https://doi.org/10.1007/s11912-021-01075-1 .
doi: 10.1007/s11912-021-01075-1 pubmed: 34716800
Bell RJ, Hakeem AR, Pandanaboyana S, Davidson BR, Prasad RK, Dasari BVM. Portal vein embolization versus dual vein embolization for management of the future liver remnant in patients undergoing major hepatectomy: meta-analysis. BJS Open. 2022;6(6):zrac131. https://doi.org/10.1093/bjsopen/zrac131 .
doi: 10.1093/bjsopen/zrac131 pubmed: 36398754 pmcid: 9673134
Vandenbroucke JP, et al. Strengthening the reporting of observational studies in epidemiology (STROBE): explanation and elaboration. Int J Surg Lond Engl. 2014;12(12):1500–24. https://doi.org/10.1016/j.ijsu.2014.07.014 .
doi: 10.1016/j.ijsu.2014.07.014
Ribero D, Chun YS, Vauthey J-N. Standardized liver volumetry for portal vein embolization. Semin Interv Radiol. 2008;25(02):104–9. https://doi.org/10.1055/s-2008-1076681 .
doi: 10.1055/s-2008-1076681
Kodama Y, Ng CS, Wu TT, Ayers GD, Curley SA, Abdalla EK, Vauthey JN, Charnsangavej C. Comparison of CT methods for determining the fat content of the liver. AJR Am J Roentgenol. 2007;188(5):1307–12. https://doi.org/10.2214/AJR.06.0992 .
doi: 10.2214/AJR.06.0992 pubmed: 17449775
Derstine BA, Holcombe SA, Ross BE, Wang NC, Su GL, Wang SC. Optimal body size adjustment of L3 CT skeletal muscle area for sarcopenia assessment. Sci Rep. 2021;11(1):279. https://doi.org/10.1038/s41598-020-79471-z .
doi: 10.1038/s41598-020-79471-z pubmed: 33431971 pmcid: 7801425
Kikinis R, Pieper SD, Vosburgh KG. 3D slicer: a platform for subject-specific image analysis, visualization, and clinical support. In: Jolesz FA, editor. Intraoperative imaging and image-guided therapy. New York: Springer; 2014. p. 277–89. https://doi.org/10.1007/978-1-4614-7657-3_19 .
doi: 10.1007/978-1-4614-7657-3_19
Filippiadis DK, Binkert C, Pellerin O, Hoffmann RT, Krajina A, Pereira PL. Cirse quality assurance document and standards for classification of complications: the cirse classification system. Cardiovasc Intervent Radiol. 2017;40(8):1141–6. https://doi.org/10.1007/s00270-017-1703-4 .
doi: 10.1007/s00270-017-1703-4 pubmed: 28584945
Nagino M, Kamiya J, Nishio H, Ebata T, Arai T, Nimura Y. Two hundred forty consecutive portal vein embolizations before extended hepatectomy for biliary cancer: surgical outcome and long-term follow-up. Ann Surg. 2006;243(3):364–72. https://doi.org/10.1097/01.sla.0000201482.11876.14 .
doi: 10.1097/01.sla.0000201482.11876.14 pubmed: 16495702 pmcid: 1448943
Huisman F, Cieslak KP, van Lienden KP, Bennink RJ, van Gulik TM. Liver related complications in unresectable disease after portal vein embolization. Hepatobiliary Surg Nutr. 2017;6(6):379–86. https://doi.org/10.21037/hbsn.2017.02.03.16] .
doi: 10.21037/hbsn.2017.02.03.16] pubmed: 29312972 pmcid: 5756764
Huang Y, Ge W, Kong Y, Ding Y, Gao B, Qian X, Wang W. Preoperative portal vein embolization for liver resection: an updated meta-analysis. J Cancer. 2021;12(6):1770–8. https://doi.org/10.7150/jca.50371.PMID:33613766;PMCID:PMC7890316 .
doi: 10.7150/jca.50371.PMID:33613766;PMCID:PMC7890316 pubmed: 33613766 pmcid: 7890316
Bilhim T, Böning G, Guiu B, et al. CIRSE standards of practice on portal vein embolization and double vein embolization/liver venous deprivation. Cardiovasc Intervent Radiol. 2024. https://doi.org/10.1007/s00270-024-03743-8 .
doi: 10.1007/s00270-024-03743-8 pubmed: 38884781

Auteurs

F De Beukelaer (F)

Department of Diagnostic and Interventional Neuroradiology, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany. fdebeukelaer@ukaachen.de.

V Van den Bosch (V)

Department of Diagnostic and Interventional Radiology, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany.

C Kuhl (C)

Department of Diagnostic and Interventional Radiology, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany.

F Pedersoli (F)

Department of Diagnostic and Interventional Radiology, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany.

P Bruners (P)

Department of Diagnostic and Interventional Radiology, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany.

Classifications MeSH