DRAGON PLC Trial Comparing Combined Portal and Hepatic Vein Embolization to Portal Vein Embolization Alone For Patients With Primary Liver Cancer Including Hepatocellular Carcinoma and Cholangiocarcinoma

What this Trial Is About

Researchers are investigating whether combining portal vein embolization PVE with hepatic vein embolization HVE improves the chances of liver surgery and overall survival in patients with initially unresectable primary liver cancers, including hepatocellular carcinoma and cholangiocarcinoma. The trial aims to see if this combined approach increases liver growth and makes surgery possible within 3 weeks, and whether it improves survival over 5 years compared to standard PVE alone. Participants will receive either standard PVE or the combined PVE and HVE procedure. PVE involves blocking blood flow to part of the liver to encourage growth of the remaining liver, while HVE adds blockage of the hepatic vein during the same session. These procedures are done using specific techniques like a transhepatic approach for PVE and transjugular or transfemoral approaches for HVE. The study compares these two approaches to see which better supports liver growth and surgery readiness. Throughout the study, participants will undergo regular imaging to check liver growth and resectability. Researchers will monitor survival outcomes for up to 5 years after the embolization procedures. The main outcomes measured include the proportion of patients able to have surgery within 3 weeks and overall survival at 5 years. The study also tracks safety and liver function to ensure participants well-being during and after treatment.

The Dragon PLC Trial (DRAGON-PLC)