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• W3201211462 abstract "Presenter: Alexandra W Acher MD | University of Wisconsin School of Medicine and Public Health Background: Portal vein embolization (PVE) and Yttrium-90 radioembolization (Y90) are two modalities used in combination with curative intent liver surgery to treat primary and metastatic tumors in the liver. As there are no multi-institutional comparisons of patients undergoing PVE vs Y90 prior to curative intent liver surgery, we sought to compare disease characteristics and post-treatment outcomes in these patient populations. Methods: Data from 2008-2019 were acquired from 7 institutions for patients undergoing PVE or Y90 prior to curative intent liver surgery. Patient and disease demographics and postoperative morbidity was compared in PVE and Y90 patients using Chi Squared test, Fischer’s exact test, Student’s T-test and ANOVA. Severity of postoperative morbidity within 90 days of surgery was quantified with Clavien-Dindo Classification (CD); severe complications were defined as CD > 4a. Given that Y90 may be used as a bridge to liver transplantation, sub-analyses were conducted for patients undergoing PVE or Y90 prior to resection (rather than transplant). Risk of post-resection morbidity was compared using logistic regression. Results: Of 239 total patients, 23% (n=56) underwent Y90 and 77% (n=183) underwent PVE; 94% of Y90 patients underwent either liver transplantation (30%) or curative intent hepatectomy (66%) and 89% of PVE underwent curative intent hepatectomy. Overall, compared to PVE patients, Y90 patients were more likely to have hepatocellular carcinoma (61% vs 15%, p1 liver directed therapy (29% vs 0%, p 1 liver directed therapy (21% vs 0%, p<0.01). PVE and Y90 patients undergoing resection had similar post-liver directed therapy future liver remnant volumes (46% +/- 15 SD vs 46% +/- 13 SD, respectively, p=0.88). PVE and Y90 patients undergoing resection also had similarly high rates of postoperative complication (59% vs 42%, respectively, p=0.06). Univariate analysis demonstrated that increasing age (p=0.03), coronary artery disease (p=0.05), and decreasing preoperative platelets (p=0.03) were associated with risk of increasingly severe postoperative complications while type of liver directed therapy was not (Table 1A). Controlling for age, coronary disease, and preoperative platelets, logistic regression confirmed that there was no difference in severity of postoperative complications between PVE vs Y90 patients undergoing curative intent hepatectomy (OR 1.7 95% CI 0.82-3.7, Table 1B). Conclusion: The incidence and severity of postoperative morbidity is equivalent in patients who undergo PVE vs Y90 prior to curative intent hepatectomy. The similar safety profile of these modalities should validate their consideration in designing patient-specific treatment approaches for primary and metastatic tumors in the liver." @default.
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• W3201211462 date "2021-01-01" @default.
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• W3201211462 title "PVE or Y90 prior to curative intent liver surgery: are there differences in post-operative outcomes?" @default.
• W3201211462 doi "https://doi.org/10.1016/j.hpb.2021.06.339" @default.
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