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Systematic review of perioperative and survival outcomes of liver resections with and without preoperative portal vein embolization for colorectal metastases

Lookup NU author(s): Sanjay PandanaboyanaORCiD


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© 2017 International Hepato-Pancreato-Biliary Association Inc.Background The aim of this systematic review was to evaluate perioperative and long term outcomes in patients who underwent PVE prior to liver resection for colorectal liver metastases. Methods A systematic search of PubMed, MEDLINE, Embase and the Cochrane library was performed in accordance with PRISMA guidelines. Studies including patients who underwent liver resection with and without PVE (N-PVE) were included. Results Thirteen studies including 1345 were included of which 539 patients had PVE and 806 had N-PVE. Eight studies reported that from a total of 450 patients who underwent PVE, 136 (30%) did not proceed to liver resection. In 114 (84%) patients this was due to disease progression. The postoperative morbidity was 42% (n = 151) after PVE and 10% (n = 35) developed postoperative liver failure after liver resection. Median overall survival, reported in all studies, was 38.9 months and 45.6 months respectively, following resection with PVE and N-PVE. The median disease free survival, reported in eight studies, was 15.7 (PVE) and 21.4 (N-PVE) months respectively. Conclusion Following PVE 70% of patients proceed to liver resection, with a 10% risk of postoperative liver failure. Tumour progression after PVE was the predominant reason for not proceeding to liver resection.

Publication metadata

Author(s): Ironside N, Bell R, Bartlett A, McCall J, Powell J, Pandanaboyana S

Publication type: Review

Publication status: Published

Journal: HPB

Year: 2017

Volume: 19

Issue: 7

Pages: 559-566

Print publication date: 01/07/2017

Online publication date: 21/04/2017

Acceptance date: 01/03/2017

ISSN (print): 1365-182X

ISSN (electronic): 1477-2574

Publisher: Elsevier B.V.


DOI: 10.1016/j.hpb.2017.03.003

PubMed id: 28438427