Predictive factors for hypertrophy of the future remnant liver after selective portal vein embolization

Ann Surg Oncol. 2010 Aug;17(8):2081-9. doi: 10.1245/s10434-010-0979-2. Epub 2010 Mar 17.


Background: To analyze predictive factors of hypertrophy of the nonembolized future remnant liver (FRL) after transhepatic preoperative portal vein embolization (PVE) of the liver to be resected.

Materials and methods: Age, gender, indocyanin green clearance test, chemotherapy before PVE, type of chemotherapy, operators, extent of PVE, radiofrequency ablation (RFA) associated with PVE, time delay between PVE and surgery, and platelet count were retrospectively evaluated as predictive factors for hypertrophy of FRL in 107 patients with malignant disease in noncirrhotic liver. PVE targeted the right liver lobe [n = 70] or the right liver lobe and segment IV [n = 37] when FRL/total liver volume ratio was below 25% in healthy liver or 40% in altered liver.

Results: After PVE, FRL volume significantly increased by 69%, from 344 +/- 156 cm(3) to 543 +/- 192 cm(3) (P < .0001). The degree of hypertrophy was negatively correlated with FRL volume (correlation coefficient = -0.55, P < .0001) and FRL/TFL ratio (correlation coefficient = -0.52, P < .0001) before PVE. Patients, who have undergone chemotherapy with platin agents prior to PVE, demonstrated lower hypertrophy (P = .048).

Conclusion: Hypertrophy after PVE is inversely correlated to initial FRL volume. Hypertrophy of the liver might be influenced by the systemic chemotherapeutic received before PVE.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Embolization, Therapeutic / adverse effects*
  • Female
  • Hepatectomy
  • Humans
  • Hypertrophy / etiology
  • Liver / pathology*
  • Liver / surgery
  • Liver Neoplasms / therapy*
  • Male
  • Middle Aged
  • Portal Vein*
  • Retrospective Studies
  • Treatment Outcome
  • Young Adult