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Future Liver Remnant Hypertrophy after Portal Vein Embolization Is Inversely Correlated with Intrahepatic Tumor Burden
Authors:Edwin A Takahashi  Chad J Fleming  James C Andrews
Institution:Department of Radiology, Division of Vascular and Interventional Radiology, Mayo Clinic, 200 First Street SW, Rochester, Minnesota, 55905
Abstract:

Purpose

To determine if there is a correlation between intrahepatic tumor volume and future liver remnant (FLR) hypertrophy after portal vein embolization (PVE).

Materials and Methods

Forty-four consecutive patients with hepatocellular carcinoma or metastatic colorectal cancer who underwent PVE from 2009 to 2017 and who had complete imaging follow-up were retrospectively reviewed. To maximize the accuracy of tumor volume measurements, 11 patients were excluded for having more than 5 intrahepatic tumors. Volumetric analyses of the patient livers before and after PVE, as well as pre-embolization intrahepatic tumor burden, were performed.

Results

A significant inverse correlation was observed between tumor volume and FLR hypertrophy after PVE (Spearman ρ = -0.53, P = .002). Initial FLR volume was also inversely correlated with subsequent hypertrophy (P = .01). Fourteen patients received neoadjuvant chemotherapy 1 month prior to intervention. The number of chemotherapy cycles did not affect hypertrophy (P = .57). Patients with cirrhosis experienced less FLR hypertrophy than patients without cirrhosis (P = .02).

Conclusions

Patients with large intrahepatic tumor burden may experience limited FLR hypertrophy.
Keywords:CRM  colorectal cancer metastases  FLR  future liver remnant  HCC  hepatocellular carcinoma  PVE  portal vein embolization
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