Safety and Efficacy of Sequential Transcatheter Arterial Chemoembolization and Portal Vein Embolization prior to Major Hepatectomy for Patients with HCC

Objective: To evaluate the safety and efficacy of sequential transcatheter arterial chemoembolization (TACE)and portal vein embolization (PVE) before major hepatectomy for patients with hepatocellur carcinoma (HCC).
Methods: In this retrospective case-control study, data were collected from patients who underwent sequentialTACE and PVE prior to major hemihepactectomy. Liver volumes were measured by computed tomographyvolumetry before TACE, and preoperation to assess degree of future remnant liver (FRL) hypertrophy and tocheck whether intro- or extrohepatic metastasis existed. Liver function was monitored by biochemistry afterTACE, prior to and after major hepatectomy.
Results: Mean average FRL volume increased 32.3-71.4% (mean55.4%) compared with preoperative FRL volume. After TACE, liver enzymes were elevated, but returned tonormal in four weeks. During PVE and resection, no patient had intro- or extrohepatic metastasis.
Conclusion:Sequential TACE and PVE is an effective method to improve resection opportunity, expand the scope of surgicalresection, and greatly reduce postoperative intra- and extrahepatic metastasis.