World Journal of Surgery

, Volume 38, Issue 2, pp 497–504

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

  • Simon A.W.G. Dello
  • Petra G. Serbanescu Kele
  • Robert J. Porte
  • Ronald M. van Dam
  • Joost M. Klaase
  • Cees Verhoef
  • Thomas van Gulik
  • Quintus Molenaar
  • Koop Bosscha
  • Eric J. van der Jagt
  • Cornelis H.C. Dejong
  • Marieke T. de Boer
Article

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

Authors and Affiliations

  • Simon A.W.G. Dello
    • 1
  • Petra G. Serbanescu Kele
    • 2
  • Robert J. Porte
    • 3
  • Ronald M. van Dam
    • 1
  • Joost M. Klaase
    • 4
  • Cees Verhoef
    • 5
  • Thomas van Gulik
    • 6
  • Quintus Molenaar
    • 7
  • Koop Bosscha
    • 8
  • Eric J. van der Jagt
    • 2
  • Cornelis H.C. Dejong
    • 1
  • Marieke T. de Boer
    • 3
  1. 1.Department of Surgery, Maastricht University Medical Center & Nutrim School for Nutrition, Toxicology and MetabolismMaastricht UniversityMaastrichtThe Netherlands
  2. 2.Department of RadiologyUniversity Medical Center Groningen, University of GroningenGroningenThe Netherlands
  3. 3.Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, University Medical Center GroningenUniversity of GroningenGroningenThe Netherlands
  4. 4.Department of SurgeryMedisch Spectrum TwenteEnschedeThe Netherlands
  5. 5.Department of Surgery, Erasmus Medical CentreErasmus UniversityRotterdamThe Netherlands
  6. 6.Department of Surgery, Academic Medical CenterUniversity of AmsterdamAmsterdamThe Netherlands
  7. 7.Department of SurgeryUniversity Medical Centre Utrecht, University of UtrechtUtrechtThe Netherlands
  8. 8.Department of SurgeryJeroen Bosch HospitalHertogenboschThe Netherlands

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