Rapid liver regeneration following PVE/HVE improves overall survival compared to PVE alone – A midterm analysis of the multicenter DRAGON 0 cohort
Bibliographic record
Abstract
Background Hypertrophy-inducing procedures, such as portal vein embolization (PVE), improve future liver remnant (FLR) volume and function and help overcome limitations to resection. Mainly due to tumor progression while awaiting sufficient liver growth, 30-40% fail to achieve surgery after PVE. In the DRAGON 0 study, simultaneous portal and hepatic vein embolization (PVE/HVE) has shown to increase FLR-hypertrophy, kinetic growth rate and resectability substantially compared to PVE alone. The purpose of this study is to compare the 3-year overall survival after PVE/HVE versus PVE in patients undergoing liver resection for primary and secondary cancers of the liver. Methods In this multicenter retrospective study, all DRAGON 0 centers provided 3-year follow-up data of all DRAGON 0-included PVE/HVE and PVE cases between 2016 and 2019. Kaplan-Meier analysis was performed to assess 3-year overall and recurrence-free survival. Factors affecting survival were analysed using uni- and multivariable cox regression analysis. Results In total, 199 patients from 7 centers were included, of which 39 underwent PVE/HVE and 160 PVE alone. Groups differed in median age (p=0.008). As reported previously, PVE/HVE resulted in a significantly higher resection rate compared to PVE alone (92% vs. 68%; p=0.007). A significant higher 3-year overall survival was observed in the PVE/HVE group (PVE/HVE: not reached after 36 months vs. PVE: 20 months, p=0.004). PVE/HVE was an independent predictor of survival in uni- and multivariable analyses (hazard ratio: 0.46 (confidence interval: 0.27-0.76), p=0.003). Conclusion Overall survival after PVE/HVE is better than after PVE alone in patients with primary and secondary liver tumors Publication History Article published online: 23 January 2024 © 2024. Thieme. All rights reserved. Georg Thieme Verlag Rüdigerstraße 14, 70469 Stuttgart, Germany
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".