DRAGON Registry - International Multicenter Registry and Medical Image Bank for Patients With Primarily Unresectable Liver Cancer or Liver Metastases That Underwent Combined Portal and Hepatic Vein Embolization (PVE/HVE) to Increase Future Liver Remnant Before Resection.

Number of complications during embolization

The number of complications occurring during liver embolization (e.g., spill to the future liver remnant).

Time frame: Perioperative

Kinetic Growth Rate [%/week]

Volumetric assessments are performed at baseline and three weeks after embolization. Changes in FLR volume will be standardized (sFLR) by calculating the ratio of the FLR to the Standardized Total Liver Volume (sTLV) using the Vauthey formula. The DH will be calculated as the percentage point difference in sFLR volume between baseline and three weeks after embolization. The KGR will then be derived from the DH, quantifying the weekly percentage volume increase observed between these measurements.

Time frame: 3 weeks after the embolization

Functional Growth Rate [%/week]

The Functional Growth Rate reflects the rate at which FLR function increases after embolization, as measured by hepatobiliary scintigraphy. FLR function is expressed in %/min/m2 at baseline and three weeks after embolization. The functional degree of hypertrophy (FDH-function) is the percentage point difference in FLR function between these time points, and the FGR is calculated by dividing the DH-function by the number of weeks elapsed.

Time frame: Three weeks after the embolization

90-day survival after embolization

90-day survival is defined as the proportion of patients alive at 90 days after liver embolization, serving as a standard measure of short-term postoperative outcome and surgical safety.

Time frame: 90 days post-embolization / post-resection

Number of complications during surgery

The number of complications occurring during liver surgery (e.g., excessive blood loss and vascular or biliary injury).

Time frame: Perioperative

90 day survival after resection

90-day survival is defined as the proportion of patients alive at 90 days after liver surgery, serving as a standard measure of short-term postoperative outcome and surgical safety.

Time frame: 90 days

Clinical resection rates

The clinical resection rate is defined as the proportion of patients who undergo liver resection among those who started embolization.

Time frame: Until MDT decision on resection (yes/no), approximately 3-6 weeks after the embolization

Number of salvage procedures

This outcome measure captures the proportion of patients in whom the FLR fails to reach a sufficient volume or function after the initial embolization procedure, and who therefore undergo an additional salvage intervention (e.g., repeat or completion embolization) to further promote FLR growth before resection can be considered

Time frame: Approximately 3-6 weeks after the embolization

Number of participants with disease recurrence

The proportion of patients who develop disease recurrence (locoregional or distant) during follow-up after liver resection.

Time frame: Until five years after the embolization/resection

Number of oncological interventions during follow up

The number of additional oncological interventions (e.g., chemotherapy, repeat liver resection, ablation, radiotherapy) administered to patients during follow-up

Time frame: Until five years after the embolization/resection