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Background: The purpose of this study was to compare 3-year overall survival after simultaneous portal (PVE) and hepatic vein (HVE) embolization versus PVE alone in patients undergoing liver resection for primary and secondary cancers of the liver., Methods: In this multicentre retrospective study, all DRAGON 0 centres provided 3-year follow-up data for all patients who had PVE/HVE or PVE, and were included in DRAGON 0 between 2016 and 2019. Kaplan-Meier analysis was undertaken to assess 3-year overall and recurrence/progression-free survival. Factors affecting survival were evaluated using univariable and multivariable Cox regression analyses., Results: In total, 199 patients were included from 7 centres, of whom 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 than PVE alone (92 versus 68%; P = 0.007). Three-year overall survival was significantly higher in the PVE/HVE group (median survival not reached after 36 months versus 20 months after PVE; P = 0.004). Univariable and multivariable analyses identified PVE/HVE as an independent predictor of survival (univariable HR 0.46, 95% c.i. 0.27 to 0.76; P = 0.003)., Conclusion: Overall survival after PVE/HVE is substantially longer than that after PVE alone in patients with primary and secondary liver tumours., (© The Author(s) 2024. Published by Oxford University Press on behalf of BJS Foundation Ltd.)

Competing Interests: Conflict of interest B.B.S. has a patent (04/10/14–20140100278): Injectable formulation for treatment and protection of patients having an inflammatory reaction or an ischemia–reperfusion event; M. Urner, L. K. Limbach, I. K. Herrmann, W. J. Stark, B. Beck-Schimmer, applied as Patent Cooperation Treaty (internationally), July 2009, as well as a patent application on bioconjugates of antibodies and functionalized magnetic nanoparticles. B.B.S. and M.S. received grant money from Sedana Medical (Danderyd, Sweden) as collaborators in a large multicentre study not related to this topic. M.S. and B.B.S. received grant money from Roche Diagnostics International (Rotkreuz, Switzerland) for a clinical trial not related to this topic. The authors declare no other conflict of interest.