Comparison of percutaneous microwave/radiofrequency ablation liver partition and portal vein embolization versus transarterial chemoembolization and portal vein embolization for planned hepatectomy with insufficient future liver remnant

BMC Cancer. 2024 Aug 9;24(1):985. doi: 10.1186/s12885-024-12666-z.

Abstract

Background: In China, both percutaneous microwave/radiofrequency ablation liver partition plus portal vein embolization (PALPP) and transarterial chemoembolization (TACE) plus portal vein embolization (PVE) have been utilized in planned hepatectomy. However, there is a lack of comparative studies on the effectiveness of these two techniques for cases with insufficient future liver remnant (FLR).

Methods: Patients were categorized into either the PALPP group or the TACE + PVE group. Clinical data, including FLR growth rate, complications, secondary resection rate, and overall survival rate, were compared and analyzed for both groups retrospectively.

Results: Between December 2014 and October 2021, a total of 29 patients underwent TACE + PVE (n = 12) and PALPP (n = 17). In the TACE + PVE group, 7 patients successfully underwent two-stage hepatectomy, while in the PALPP group, 13 patients underwent the procedure (two-stage resection rate: 58.3% vs. 76.5%, P = 0.42). There were no significant differences in postoperative complications of one-stage procedures (11.8% vs. 8.3%, P > 0.05) and second-stage resection complication (0% vs. 46.2%, P = 0.05) between the TACE + PVE and PALPP groups. However, the PALPP group demonstrated a shorter time to FLR volume growth for second-stage resection (18.5 days vs. 66 days, P = 0.001) and KGR (58.5 ml/week vs. 7.7 ml/week, P = 0.001).

Conclusions: Compared with TACE + PVE, PALPP results in a more significant increase in FLR volume and a higher rate of two-stage resection without increasing postoperative complications.

Keywords: Future liver remnant; Liver partition; Microwave/radiofrequency ablation; Planned hepatectomy; Portal vein mbolization; Transarterial chemoembolization.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Carcinoma, Hepatocellular* / surgery
  • Carcinoma, Hepatocellular* / therapy
  • Chemoembolization, Therapeutic* / methods
  • China / epidemiology
  • Combined Modality Therapy
  • Embolization, Therapeutic / methods
  • Female
  • Hepatectomy* / methods
  • Humans
  • Liver / blood supply
  • Liver / surgery
  • Liver Neoplasms* / surgery
  • Liver Neoplasms* / therapy
  • Male
  • Microwaves* / therapeutic use
  • Middle Aged
  • Portal Vein*
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Radiofrequency Ablation* / methods
  • Retrospective Studies
  • Survival Rate
  • Treatment Outcome