Open AccessRadioembolisation and portal vein embolization before resection of large hepatocellular carcinoma
Author(s) -
Fikri Bouazza,
Arthur Poncelet,
Camilo Garcia,
Philippe Delatte,
Jean Luc Engelhom,
María Gómez Galdón,
Amélie Deleporte,
Alain Hendlisz,
Bruno Vanderlinden,
Patrick Flamen,
Vincent Donckier
Publication year - 2015
Publication title -
world journal of gastroenterology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.427
H-Index - 155
eISSN - 2219-2840
pISSN - 1007-9327
DOI - 10.3748/wjg.v21.i32.9666
Subject(s) - medicine , hepatocellular carcinoma , hepatectomy , embolization , muscle hypertrophy , portal vein embolization , radiology , liver tumor , pathological , decompensation , surgery , resection
Resectability of hepatocellular carcinoma in patients with chronic liver disease is dramatically limited by the need to preserve sufficient remnant liver in order to avoid postoperative liver insufficiency. Preoperative treatments aimed at downsizing the tumor and promoting hypertrophy of the future remnant liver may improve resectability and reduce operative morbidity. Here we report the case of a patient with a large hepatocellular carcinoma arising from chronic liver disease. Preoperative treatment, including tumor downsizing with transarterial radioembolization and induction of future remnant liver hypertrophy with right portal vein embolization, resulted in a 53% reduction in tumor volume and compensatory hypertrophy in the contralateral liver. The patient subsequently underwent extended right hepatectomy with no postoperative signs of liver decompensation. Pathological examination demonstrated a margin-free resection and major tumor response. This new therapeutic sequence, combining efficient tumor targeting and subsequent portal vein embolization, could improve the feasibility and safety of major liver resection for hepatocellular carcinoma in patients with liver injury.