Portal Vein Embolization Effects On Patients With Hepatocellular Carcinoma

Background:Hepatocellular carcinoma (HCC) is one of the most prevalent cancer worldwide. The only curative treatment for malignant liver tumors is liver resection. Portal vein embolization(PVE) is worldwide accepted to increase the future remnant liver(FRL) to increase the resectability rate of patients with advanced liver carcinoma. However, the long-term outcome of the hypertrophy of the nonembolized future remnant liver after Portal vein embolization remains unknown.Aims:To evaluate the safety end efficacy of portal vein embolization prior to surgery in hepatocellular carcinoma (HCC) patients and to compare the clinical outcome of the patients undergoing portal vein embolization and those did not experience PVE.Methods:From Jan1st,2011to Dec20th,2012,48patients with HCC undergoing TACE+PVE+right hepatectomy, TACE+right hepatectomy and right hepatectomy alone were included.In each group, CT scan and liver volume were performed before and4weeks after PVE to assess degree of left lobe hypertrophy.Results:Baseline patients in each group were similar. Though, the PVE group had a larger tumor size (8.6±2.9cm, P=0.019), the overall survival among the three groups showed no significant difference. Before and after PVE, the liver enzymes and other parameters of liver functions were similar (P>0.05). There were no statistically significant differences of the tumor sizes and numbers before and after PVE. The mean increase in percentage FLR volume between the group of patients with liver cirrhosis and not suggest no marked difference (26.6±20.7%vs50.4±24.0%, P=0.116).Conclusions:Sequential TACE and PVE before surgery is a safe and effective way to increase the liver volume of FLR after right hepatectomy, and maybe leads to better survival in patients with advanced HCC.