Editorial
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Mar 21, 2015; 21(11): 3170-3173
Published online Mar 21, 2015. doi: 10.3748/wjg.v21.i11.3170
Contra-lateral liver lobe hypertrophy after unilobar Y90 radioembolization: An alternative to portal vein embolization?
Jin-Yao Teo, Brian KP Goh
Jin-Yao Teo, Brian KP Goh, Department of Hepatopancreatobiliary and Transplantation Surgery, Singapore General Hospital, Singapore 169856, Singapore
Brian KP Goh, Duke-NUS Graduate Medical School, Singapore 169857, Singapore
Author contributions: Teo JY performed the literature search, retrieved data and wrote the paper; Goh BKP was responsible for conception and design of the paper, wrote the paper and made critical revisions.
Conflict-of-interest: Goh BKP has received travel grants from Sirtex Medical.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Brian KP Goh, MBBS, MMed, MSc, FRCSEd, Senior Consultant and Associate Professor (Adj), Department of Hepatopancreatobiliary and Transplantation Surgery, Singapore General Hospital, 20 College Road, Academia Level 5, Singapore 169856, Singapore. bsgkp@hotmail.com
Telephone: +65-63265564 Fax: +65-62209323
Received: October 16, 2014
Peer-review started: October 18, 2014
First decision: October 29, 2014
Revised: November 11, 2014
Accepted: February 12, 2015
Article in press: February 13, 2015
Published online: March 21, 2015
Abstract

Liver resection (LR) with negative margins confers survival advantage in many patients with hepatic malignancies. However, an adequate future liver remnant (FLR) is imperative for safe LR. Presently, in patients with an inadequate FLR; the 2 most established clinical techniques performed to induce liver hypertrophy are portal vein embolization (PVE) and portal vein ligation. More recently, it has been observed that patients who undergo treatment via Y90 radioembolization experience hypertrophy of the contra-lateral untreated liver lobe. Based on these observations, several investigators have proposed the potential use of this modality as an alternative technique for increasing the FLR prior to liver resection. Y90 radioembolization induces hypertrophy at a slower rate than PVE but has the added advantage of concomitant local disease control and tumour down-staging.

Keywords: Liver hypertrophy, Y90, Radioembolization, Portal vein embolization, Selective internal radiation therapy

Core tip: Both portal vein embolization and Y90 radioembolization induce significant hypertrophy of the contralateral lobe. Y90 radioembolization induces hypertrophy at a slower rate than PVE but has the added advantage of concomitant local disease control and tumour down-staging.