Dragon 2 - Eine internationale, randomisierte, kontrollierte Studie von mehreren Zentren welche zwei unterschiedliche Techniken, welche zur Steigerung der Lebergrösse führen, miteinander vergleicht.

Procedure: Embolization

Gender: All
Maximum age: N/A
Minimum age: 18 Years

Inclusion Criteria:

- Patients with primarily unresectable/ potentially resectable CRLM with a FLR <30%
(<40% in chemotherapy damaged livers)

- Patients with non-resected primary CRC may be included if there is an intention to
resect the CRC after the liver treatment (liver first approach) or simultaneously
during one of the liver procedures.

- Patients with resectable or ablatable lung or brain metastases can be included
(statement about the resectability of these extrahepatic metastases by a tumor board
needs to be available)

- 18 Years and older

- Men and women

- Able to understand the trial and provide informed consent.

Exclusion Criteria:

- Pregnant or lactating female.

- Premenopausal females not able or willing to commit to oral contraception

- Patients with prohibitive comorbidities, decision made by local team

- Any patient with non-resectable or non-ablatable extrahepatic disease

- Patients with hepatic malignancies other than CRLM

- Progression of disease by RECIST criteria after cytoreduction chemotherapy

- Complete response after conversion chemotherapy

- Staging CT and (if indicated) CT/MRI brain that demonstrates non-resectable
extrahepatic disease

- The anatomy of the liver or manifestation of tumors in relation to the liver veins
prohibits the use of combined PVE/HVE.