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
Remon Korenblik, Jan Heil, Jens Smits, S. James, Bram Olij, Wolf O. Bechstein, Marc H.A. Bemelmans, Christoph A. Binkert, Stefan Breitenstein, Michael D. Williams, Olivier Detry, Maxime Dewulf, Alexandra Dili, Lukasz F. Grochola, Jon Grote, Daniel Heise, Jennifer Kalil, Peter Metrakos, Ulf P. Neumann, Sam G. Pappas, Francesca Pennetta, Andreas A. Schnitzbauer, Jordan Tasse, Björn Winkens, Steven W.M. Olde Damink, Christiaan van der Leij, Erik Schadde, Ronald M. van Dam, DRAGON trials collaborative, Luca Aldrighetti, Laurens van Baardewijk, Louise Barbier, Christoph A. Binkert, Bergþór Björnsson, Cugat Andorrà E, Bülent Arslan, Ivan Baclija, Marc H.A. Bemelmans, Clare Bent, Marieke T. de Boer, Reinoud P.H. Bokkers, D. Boo, D Breen, Stefan Breitenstein, Philipp Bruners, Alberta Cappelli, Ulrik Carling, M Casellas i Robert, B Chan, Francesco De Cobelli, Chihwan Cha, J Choi, Michael Crawford, Daniel Croagh, Ronald M. van Dam, F Deprez, Olivier Detry, Maxime Dewulf, Rafael Díaz-Nieto, Alexandra Dili, Joris I. Erdmann, J Codina Font, R Davis, Martin Delle, R Fernando, Oliver M. Fisher, S M G Fouraschen, Åsmund Avdem Fretland, Y. Fundora, Arantxa Gelabert, Laurent Gérard, Paul D. Gobardhan, Fernando Gómez, F Guiliante, Thomas Gruenberger, L F Grochola, Dirk J. Grünhagen, J Guitart Giménez, Jeroen Hagendoorn, Jan Heil, Daniel Heise, Eduardo Ferrero Herrero, Gabriel Fridolin Hess, Mohammad Abu Hilal, Michael Hoffmann, Roberto Iezzi, Farshad Imani, N Inmutto, S James, F. García Borobia, Elio Jovine, Jennifer Kalil, P Kingham, Otto Kollmar, Jörg Kleeff, Christiaan van der Leij, Santiago López‐Ben, Andrew Macdonald, Martijn R. Meijerink, Remon Korenblik
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.