ALLPS VERSUS PVO Randomized Controlled Trial

Inclusion criteria: •Patient may have primary or secondary hepatic malignancies with a FLR/TLV \< 30% or a FLR/BW ratio of \< 0.5 for patients with normal liver function (defined as normal transaminases, normal bilirubin, normal factor V, and normal PT/INR). In case of injury due to chemotherapy, known high grade steatosis, or cholestasis \> 50 mmol/L, patient may be enrolled into the trial if FLR/TLV is \< 40% or FLR/BW ratio \< 0.8. * Patient must have extensive liver tumors that would require portal vein embolization or a two-stage hepatectomy and portal vein embolization or ligation by the judgment of surgeons in the tumor board. * Patient may have extrahepatic disease as long as it may be addressed after liver surgery and there is a tumor board decision to proceed with liver resection (mostly applicable to CRC metastases). * Patient may have received previous chemotherapy. * In cases of cholestasis, preoperative drainage procedures (PTC or ERCP) are left up to judgement of physicians. * Patient must be = 18 years of age. The patient population over 65 years old needs to be carefully included based on comorbidities. * Patient may have undergone previous liver resection. * Patient's location must be such that proper staging and follow-up may be performed. * Patient's case must be presented at the Multidisciplinary Meeting attended by hepatobiliary surgeons, oncologists, hepatologists, and radiologists, or must be approved directly by Dr. Strasberg or Dr. Chapman. Exclusion criteria: •Patient must not have any significant concomitant diseases rendering him/her unsuitable for major liver surgery by the judgment of the physicians involved, especially if the patient is \> 65 years old. * Patient must not have enrolled into a clinical trial within 4 weeks of study entry. * Patient must not have peritoneal carcinomatosis or other extensive extrahepatic disease. * Patient must not have advanced stages of carcinoma of the gallbladder (T3/T4) * Patient must not have issues such as drug and/or alcohol abuse. * Patient must not need major extrahepatic surgery (e.g. pancreas resection, gastric resection, rectal surgery) within 3 months of study entry. * Patient must not be a candidate for liver transplantation in case of HCC. * Patient must not be pregnant or breastfeeding. If a female of childbearing potential, patient must have a negative pregnancy test within 14 days of enrollment.