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Review
. 2012 Nov;1(3-4):159-67.
doi: 10.1159/000343829.

Portal vein embolization for hepatocellular carcinoma

Junichi Shindoh  1 , Ching-Wei D Tzeng, Jean-Nicolas Vauthey
Affiliations
Review

Portal vein embolization for hepatocellular carcinoma

Junichi Shindoh et al. Liver Cancer. 2012 Nov.

Abstract

Portal vein embolization (PVE) improves the safety of major hepatectomy through hypertrophy of the future liver remnant (FLR), atrophy of the liver volume to be resected, and improvement in patient selection. Because most patients with hepatocellular carcinoma (HCC) have liver parenchymal injury due to underlying viral hepatitis or alcoholic liver fibrosis/cirrhosis, indication of PVE is relatively complex and sequential procedures, including transarterial chemoembolization, are required to maximize the effect of PVE as well as to minimize tumor progression due to increased arterial flow after PVE. PVE is currently indicated for patients with relatively well-preserved hepatic function [Child-Pugh A and indocyanine green tolerance test (ICG-R15) <20%) to achieve minimal FLR volume for safe major hepatectomy. FLR volume >40% is the minimal requirement for patients with chronic hepatitis or cirrhosis, and further strict criteria (FLR volume >50%) have been recommended for patients with marginal liver functional reserve (ICG-R15, 10-20%). Recent clinical results have suggested that PVE can be safely performed in patients with HCC and that it contributes to improved survival after major hepatectomy.

Keywords: Hepatocellular Carcinoma; Portal Vein Embolization; Transarterial Chemoembolization.

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Figures

Fig. 1
Fig. 1
Volume changes in FLR and embolized liver postPVE.
Fig. 2
Fig. 2
Indications of PVE for patients with HCC.
See this image and copyright information in PMC

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