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Perioperative complications in patients undergoing major liver resection with or without neoadjuvant chemotherapy

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Journal of Gastrointestinal Surgery

Abstract

Systemic chemotherapy is used increasingly prior to resection of hepatic colorectal metastases. Previous reports have indicated an increased risk of perioperative complications associated with the use of systemic chemotherapy prior to resection. The purpose of this study was to investigate perioperative complications in patients receiving neoadjuvant systemic chemotherapy consisting of 5-fluorouracil (5-FU) and leucovorin (LV) with or without CPT-11 within 6 months of major liver resection. A retrospective review of 108 patients undergoing major liver resection for colorectal metastases with curative intent from 1997 to 2002 was performed. Patient and tumor characteristics, perioperative parameters, and morbidity and mortality were measured. Forty-seven patients (44%) received no chemotherapy, 27 patients (25%) received systemic 5-FU/LV, and 34 (31%) received systemic 5-FU/LV/CPT-11. A significantly higher number of patients in the group treated with preoperative 5-FU/LV plus CPT-11 had multiple tumors. Patients in this group also tended to have smaller tumors, fewer complications, and a higher R0 margin resection rate, but these findings were not statistically significant. Median blood loss and length of hospital stay were also not significantly different. There were no perioperative deaths. We conclude that the use of fluoropyrimidine-based chemotherapy and CPT-11 prior to major liver resection is not associated with increased morbidity or mortality. It may therefore provide a better therapeutic option, particularly in patients with multiple colorectal metastases.

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Author information

Authors and Affiliations

  1. Department of Surgical Oncology, Unit 444, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd., 77030-4009, Houston, TX

    Alexander A. Parikh M.D., Bernhard Gentner M.D., Steven A. Curley M.D., Lee M. Ellis M.D. & Jean-Nicolas Vauthey M.D.

  2. Department of Pathology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas

    Tsung-Teh Wu M.D., Ph.D.

Authors
  1. Alexander A. Parikh M.D.
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  2. Bernhard Gentner M.D.
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  3. Tsung-Teh Wu M.D., Ph.D.
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  4. Steven A. Curley M.D.
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  5. Lee M. Ellis M.D.
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  6. Jean-Nicolas Vauthey M.D.
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Correspondence to Jean-Nicolas Vauthey M.D..

Additional information

Presented as an abstract at the Fourth Biennial Congress of the American Hepato-Pancreato-Biliary Association (AHPBA), Miami Beach, Florida, February 27–March 2, 2003.

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Parikh, A.A., Gentner, B., Wu, TT. et al. Perioperative complications in patients undergoing major liver resection with or without neoadjuvant chemotherapy. J Gastrointest Surg 7, 1082–1088 (2003). https://doi.org/10.1016/j.gassur.2003.08.005

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  • DOI: https://doi.org/10.1016/j.gassur.2003.08.005

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