Published online Mar 21, 2015. doi: 10.3748/wjg.v21.i11.3170
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
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.
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.