World Journal of Surgery

, Volume 38, Issue 2, pp 497–504

Influence of Preoperative Chemotherapy on CT Volumetric Liver Regeneration Following Right Hemihepatectomy

Authors

    • Department of Surgery, Maastricht University Medical Center & Nutrim School for Nutrition, Toxicology and MetabolismMaastricht University
  • Petra G. Serbanescu Kele
    • Department of RadiologyUniversity Medical Center Groningen, University of Groningen
  • Robert J. Porte
    • Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, University Medical Center GroningenUniversity of Groningen
  • Ronald M. van Dam
    • Department of Surgery, Maastricht University Medical Center & Nutrim School for Nutrition, Toxicology and MetabolismMaastricht University
  • Joost M. Klaase
    • Department of SurgeryMedisch Spectrum Twente
  • Cees Verhoef
    • Department of Surgery, Erasmus Medical CentreErasmus University
  • Thomas van Gulik
    • Department of Surgery, Academic Medical CenterUniversity of Amsterdam
  • Quintus Molenaar
    • Department of SurgeryUniversity Medical Centre Utrecht, University of Utrecht
  • Koop Bosscha
    • Department of SurgeryJeroen Bosch Hospital
  • Eric J. van der Jagt
    • Department of RadiologyUniversity Medical Center Groningen, University of Groningen
  • Cornelis H.C. Dejong
    • Department of Surgery, Maastricht University Medical Center & Nutrim School for Nutrition, Toxicology and MetabolismMaastricht University
  • Marieke T. de Boer
    • Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, University Medical Center GroningenUniversity of Groningen
Article

DOI: 10.1007/s00268-013-2278-0

Cite this article as:
Dello, S.A., Kele, P.G.S., Porte, R.J. et al. World J Surg (2014) 38: 497. doi:10.1007/s00268-013-2278-0

Abstract

Background

An increasing number of patients undergo major liver resection following preoperative chemotherapy. Liver regeneration may be impaired in these patients, predisposing them to postoperative liver dysfunction. The aim of the present study was to evaluate the effects of preoperative chemotherapy on liver regeneration after partial liver resection.

Methods

Patients planned to receive right hepatectomy either with (group B) or without (group A) prior chemotherapy were identified retrospectively from a prospective multi-institutional database created in the conduct of a national randomized controlled trial (RCT). Prior chemotherapy was neither an inclusion nor an exclusion criterion of the trial. Future remnant liver volume (FRLV) was calculated by measuring total functional liver volume and resection specimen on preoperative computed tomography (CT) scans. Remnant liver volume after 7 days (VRLV7days) was measured on scheduled postoperative CT scans. The early regeneration index 7 days after surgery (RIearly) was calculated as [(VRLV7days − FRLV) / FRLV] × 100 %. Data are expressed as median (interquartile range).

Results

A total of 72 patients were enrolled: 45 in group A and 27 in group B. For the whole group, the liver remnant showed a 58 % (39 %) increase in volume at day 7 (1) day. The RIearly was not significantly different between groups A and B, 60 % (36 %) and 50 % (43 %), respectively (p = 0.47). The RIearly was significantly lower in patients who had undergone more than six cycles of chemotherapy.

Conclusions

Preoperative chemotherapy does not seem to have a negative impact on early liver regeneration after partial liver resection.

Supplementary material

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Copyright information

© Société Internationale de Chirurgie 2013