DRAGON 1 - Training, Akreditierung, Implementierung und Sicherheitsevaluation des kombinierten Verschlusses von Portalvene und Lebervenen zur Vorbereitung eines kleinen Leberrestes vor ausgedehnten Leberresektionen

Procedure: Portal and Hepatic Vein Embolization

Inclusion Criteria:

- Patients with primarily unresectable/potentially resectable CRLM after conversion
chemotherapy with a FLR <30% in normal livers, or 40% in livers chemotherapy damaged
livers.

- 18 years and older

- Patients up to ECOG 3 (not more than 50% bedbound)

- Patients with non-resected primary colorectal cancer (CRC) may be included if and only
if there is an intent to remove the CRC after the liver treatment (liver first
approach)

- Staging CT chest and (if symptomatic) CT/MRI excludes unresectable extrahepatic
disease, while metastatic disease that may be cured in the future, is included.

- Patients with resectable lung metastases or lung metastases that and be ablated can be
included only after statement about resectability/ablatability by tumor board

- Patients have to be to understand the trial and provide informed consent.

Exclusion Criteria:

- Patients with extrahepatic disease other than lung metastases

- Patients with metastatic disease to the lung that cannot be ablated or resected will
be excluded

- Patients with intrahepatic Cholangiocarcinoma (IHCC)

- Patients with Perihilar Cholangiocarcinoma (PHCC)

- Patients with Hepatocellular Carcinoma (HCC)

- Pregnant or lactating women will not be eligible

- Potential to get pregnant has to be excluded (obligatory contraception etc.)

- Progression by modified RECIST criteria on cross-sectional imaging after conversion
chemotherapy is an exclusion criterion. Complete response in cross-sectional imaging
after conversion chemotherapy.