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Colorectal Liver Metastases Growth in the Embolized and Non-Embolized Liver After Portal Vein Embolization: Influence of Initial Response to Induction Chemotherapy

  • Hepatobiliary Tumors
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Purpose

To compare tumor progression in both embolized and non-embolized liver lobes after portal vein embolization (PVE) in patients with bilobar colorectal liver metastases (CLM), according to the initial response to induction chemotherapy.

Methods

From 2002 to 2012, a total of 42 consecutive patients with bilobar CLM initially treated using induction chemotherapy underwent right PVE to achieve adequate future liver remnant volume. Tumoral and liver parenchyma volumes, as well as their volume variations, were measured on computed tomography before and after PVE in both embolized and non-embolized. Patients were classified as fast (≤6 cycles of induction chemotherapy) and slow (>6 cycles) responders.

Results

Overall, 432 metastases were analyzed in 42 patients. Patients were slow responders in 29 (69 %) cases. Tumoral volume increased in 29 (69 %) cases in the embolized liver (+48 %; p < 0.0001), and in 28 (66 %) cases in the non-embolized liver (+31 %; p < 0.0001). Fast responders had a tumoral volume decrease in both embolized (−4 %) and non-embolized (−9 %) lobes. On the opposite side, slow responders had tumoral volume increase in both embolized (+79 %) and non-embolized (+32 %) lobes. On multivariate analysis, a ‘slow’ response to induction chemotherapy was the only factor associated with tumoral progression in both embolized (p = 0.0012) and non-embolized (p = 0.001) lobes.

Conclusion

Tumor growth after PVE is observed in both embolized and non-embolized liver lobes in most patients but is significantly associated with slow response to induction chemotherapy.

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Conflicts of interest

Romain Pommier, Maxime Ronot, François Cauchy, Sébastien Gaujoux, David Fuks,Sandrine Faivre, Jacques Belghiti, and Valérie Vilgrain have no conflicts of interest.

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Authors and Affiliations

  1. Department of Radiology, Beaujon Hospital (AP-HP), Beaujon University Hospitals Paris Nord Val de Seine, Clichy, Hauts-de-Seine, France

    Romain Pommier MD, Maxime Ronot MD, PhD & Valérie Vilgrain MD, PhD

  2. Sorbonne Paris Cité, University Paris Diderot, Paris, France

    Maxime Ronot MD, PhD, François Cauchy MD, Sébastien Gaujoux MD, PhD, David Fuks MD, PhD, Sandrine Faivre MD, PhD, Jacques Belghiti MD & Valérie Vilgrain MD, PhD

  3. INSERM U1149, Centre de Recherche Biomédicale Bichat-Beaujon, Paris, France

    Maxime Ronot MD, PhD & Valérie Vilgrain MD, PhD

  4. Department of Surgery, Beaujon Hospital (AP-HP), University Hospitals Paris Nord Val de Seine, Clichy, France

    François Cauchy MD, Sébastien Gaujoux MD, PhD, David Fuks MD, PhD & Jacques Belghiti MD

  5. Department of Medical Oncology, Beaujon Hospital (AP-HP), University Hospitals Paris Nord Val de Seine, Clichy, Hauts-de-Seine, France

    Sandrine Faivre MD, PhD

Authors
  1. Romain Pommier MD
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  2. Maxime Ronot MD, PhD
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  3. François Cauchy MD
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  7. Jacques Belghiti MD
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Correspondence to Maxime Ronot MD, PhD.

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Romain Pommier and Maxime Ronot contributed equally to this article and both should be considered as first authors

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Pommier, R., Ronot, M., Cauchy, F. et al. Colorectal Liver Metastases Growth in the Embolized and Non-Embolized Liver After Portal Vein Embolization: Influence of Initial Response to Induction Chemotherapy. Ann Surg Oncol 21, 3077–3083 (2014). https://doi.org/10.1245/s10434-014-3700-z

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  • DOI: https://doi.org/10.1245/s10434-014-3700-z

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