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  • Title: The Relationship Between Postoperative Chemotherapy and Remnant Liver Regeneration and Outcomes After Hepatectomy for Colorectal Liver Metastasis.
    Author: Inoue Y, Fujii K, Ishii M, Kagota S, Hamamoto H, Osumi W, Terasawa T, Tsuchimoto Y, Masubuchi S, Yamamoto M, Asai A, Komeda K, Fukunishi S, Hirokawa F, Goto M, Narumi Y, Higuchi K, Uchiyama K.
    Journal: J Gastrointest Surg; 2019 Oct; 23(10):1973-1983. PubMed ID: 30187326.
    Abstract:
    BACKGROUND: Postoperative chemotherapy for treating colorectal liver metastasis (CLM) has been introduced with the aim of improving therapeutic outcomes. However, there is no consensus on the utility of multidisciplinary treatments with postoperative chemotherapy. Therefore, we evaluated surgical outcomes in patients with CLMs who underwent hepatectomy, while focusing on the effects of post-hepatectomy chemotherapy on remnant liver regeneration. METHODS: Two hundred ninety patients who underwent hepatectomy were retrospectively analyzed using propensity score matching. Postoperative outcomes were evaluated with a focus on the effects of post-hepatectomy chemotherapy on regeneration of the remnant liver in patients with CLM. The remnant liver volumes (RLVs) were measured postoperatively using multi-detector computed tomography on day 7 and months 1, 2, 5, and 12 after the operation. RESULTS: RLV regeneration and postoperative blood laboratory data did not differ significantly between patients who received postoperative chemotherapy and those who did not receive postoperative chemotherapy immediately after surgery or at any time point from postoperative day 7 to postoperative month 12. The recurrence rates, including same and other segmental intrahepatic recurrences, as well as the resection frequency of the remnant liver were not significantly different between the two groups. CONCLUSION: Postoperative chemotherapy may be of small significance for patients with CLM in terms of the remnant liver volume regeneration and functional recovery.
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