Abstract
Radioembolization with 90Y-microspheres has been reported to induce contralateral liver hypertrophy with simultaneous ipsilateral control of tumor growth. The aim of the present systematic review was to summarize the evidence of contralateral liver hypertrophy and oncological outcome following unilateral treatment with radioembolization. A systematic literature search using the MEDLINE, EMBASE, and Cochrane libraries for studies published between 2008 and 2020 was performed. A total of 16 studies, comprising 602 patients, were included. The median kinetic growth rate per week of the contralateral liver lobe was 0.7% and declined slightly over time. The local tumor control was 84%. Surgical resection after radioembolization was carried out in 109 out of 362 patients (30%). Although the available data suggest that radioembolization prior to major hepatectomy is safe with a promising oncological outcome, the definitive role of radioembolization requires assessment within controlled clinical trials.
Highlights
Extended liver resection for primary and secondary hepatic malignancies is dependent on an adequate future liver remnant (FLR) volume [1,2]
The present review demonstrates a significant amount of contralateral lobe hypertrophy following
The only available prospective study was published in a small cohort of 24 patients with palliative treatment of advanced hepatocellular carcinoma [31]
Summary
Extended liver resection for primary and secondary hepatic malignancies is dependent on an adequate future liver remnant (FLR) volume [1,2]. Preoperative measures to increase the volume of the FLR are effective in preventing posthepatectomy liver failure in marginally resectable disease, underlying liver cirrhosis, or heavily pretreated patients [3,4]. These interventions include selective occlusion of the contralateral portal venous supply via portal vein ligation or portal vein embolization (PVE) [5]. Tumor progression during the hypertrophy period after PVE has remained an unsolved issue and prevents subsequent hepatectomy in up to 40% of patients [6,7]. The Cancers 2020, 12, 294; doi:10.3390/cancers12020294 www.mdpi.com/journal/cancers
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