Liver regeneration after portal and hepatic vein embolization improves overall survival compared with portal vein embolization alone: mid-term survival analysis of the multicentre DRAGON 0 cohort.

Korenblik, Remon;Heil, Jan;Smits, Jens;James, Sinead;DRAGON trials collaborative;et.al.
(2024) British Journal of Surgery — Vol. 111, n° 4, p. znae087 [1-9] (2024)

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Authors
  • Korenblik, Remonorcid-logo
    Author
  • Heil, Jan
    Author
  • Smits, Jens
    Author
  • James, Sinead
    Author
  • Dili, AlexandraUCLouvain
    Author
  • DRAGON trials collaborative
    Collaborator
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Abstract
BACKGROUND: The purpose of this study was to compare 3-year overall survival after simultaneous portal (PVE) and hepatic vein (HVE) embolization versus PVE alone in patients undergoing liver resection for primary and secondary cancers of the liver. METHODS: In this multicentre retrospective study, all DRAGON 0 centres provided 3-year follow-up data for all patients who had PVE/HVE or PVE, and were included in DRAGON 0 between 2016 and 2019. Kaplan-Meier analysis was undertaken to assess 3-year overall and recurrence/progression-free survival. Factors affecting survival were evaluated using univariable and multivariable Cox regression analyses. RESULTS: In total, 199 patients were included from 7 centres, of whom 39 underwent PVE/HVE and 160 PVE alone. Groups differed in median age (P = 0.008). As reported previously, PVE/HVE resulted in a significantly higher resection rate than PVE alone (92 versus 68%; P = 0.007). Three-year overall survival was significantly higher in the PVE/HVE group (median survival not reached after 36 months versus 20 months after PVE; P = 0.004). Univariable and multivariable analyses identified PVE/HVE as an independent predictor of survival (univariable HR 0.46, 95% c.i. 0.27 to 0.76; P = 0.003). CONCLUSION: Overall survival after PVE/HVE is substantially longer than that after PVE alone in patients with primary and secondary liver tumours.
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Korenblik, R., Heil, J., Smits, J., James, S., Olij, B., Bechstein, W. O., Bemelmans, M. H. A., Binkert, C. A., Breitenstein, S., Williams, M., Detry, O., Dewulf, M. J. L., Dili, A., Grochola, L. F., Grote, J., Heise, D., Kalil, J. A., Metrakos, P., Neumann, U. P., et al. (2024). Liver regeneration after portal and hepatic vein embolization improves overall survival compared with portal vein embolization alone: mid-term survival analysis of the multicentre DRAGON 0 cohort. British Journal of Surgery, 111(4), znae087 [1-9]. https://doi.org/10.1093/bjs/znae087 (Original work published 2024)