Portal vein embolization prior to resection of colorectal liver metastases does not impact oncological outcomes

Abstract

Background: Concerns have been raised concerning tumour progression after PVE. This study aimed to compare the survival outcomes of patient subjected to major liver resection for colorectal liver metastases with or without PVE. To reduce selection bias, PVE patients were matched to non-PVE patients using propensity score matching with as primary endpoints overall and disease-free survival. Methods: All consecutive patients who underwent major liver resection for colorectal liver metastases at three academic medical centers between January 2000 and December 2015 were included. For a propensity matched comparison, all patients who underwent PVE before major liver resection were selected. Patients were matched to patients who had undergone major liver resection without PVE. Results: Of 745 patients undergoing major liver resection for CRLM, a total of 46 patients who underwent PVE had sufficient data and were matched. Both disease-free and overall survival were comparable between the two groups after matching. Conclusion: Comparable disease free survival and overall survival were found in patients who underwent portal vein embolization before major liver resection compared to matched controls treated with major surgery alone. PVE is a valuable tool to improve resectability rate of patients with colorectal liver metastases and does not affect long term oncological outcomes in patients proceeding with liver resection.