Skip to main content
Erschienen in: Journal of Gastrointestinal Surgery 10/2019

05.09.2018 | Original Article

The Relationship Between Postoperative Chemotherapy and Remnant Liver Regeneration and Outcomes After Hepatectomy for Colorectal Liver Metastasis

verfasst von: Yoshihiro Inoue, Kensuke Fujii, Masatsugu Ishii, Syuji Kagota, Hiroki Hamamoto, Wataru Osumi, Tetsuji Terasawa, Yusuke Tsuchimoto, Shinsuke Masubuchi, Masashi Yamamoto, Akira Asai, Koji Komeda, Shinya Fukunishi, Fumitoshi Hirokawa, Masahiro Goto, Yoshihumi Narumi, Kazuhide Higuchi, Kazuhisa Uchiyama

Erschienen in: Journal of Gastrointestinal Surgery | Ausgabe 10/2019

Einloggen, um Zugang zu erhalten

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.
Literatur
1.
Zurück zum Zitat Suzuki S, Sakaguchi T, Yokoi Y, Kurachi K, Okamoto K, Okumura T, et al. Impact of repeat hepatectomy on recurrent colorectal liver metastases. Surgery 2001;129:421–428.CrossRef Suzuki S, Sakaguchi T, Yokoi Y, Kurachi K, Okamoto K, Okumura T, et al. Impact of repeat hepatectomy on recurrent colorectal liver metastases. Surgery 2001;129:421–428.CrossRef
2.
Zurück zum Zitat Nakamura S, Suzuki S, Konno H. Resection of hepatic metastases of colorectal carcinoma: 20 years’ experience. J Hep Bil Pancr Surg 1999;1:16–22.CrossRef Nakamura S, Suzuki S, Konno H. Resection of hepatic metastases of colorectal carcinoma: 20 years’ experience. J Hep Bil Pancr Surg 1999;1:16–22.CrossRef
3.
Zurück zum Zitat Pawlik TM, Schlick RD, Choti MA. Expanding criteria for resectability of colorectal liver metastases. Oncologist 2008;13:51–64.CrossRef Pawlik TM, Schlick RD, Choti MA. Expanding criteria for resectability of colorectal liver metastases. Oncologist 2008;13:51–64.CrossRef
4.
Zurück zum Zitat Assumpcao L, Choti MA, Gleisner AL, Schulick RD, Swartz M, Herman J, et al. Patterns of recurrence following liver resection for colorectal metastases. Arch Surg 2008;143:743–749.CrossRef Assumpcao L, Choti MA, Gleisner AL, Schulick RD, Swartz M, Herman J, et al. Patterns of recurrence following liver resection for colorectal metastases. Arch Surg 2008;143:743–749.CrossRef
5.
Zurück zum Zitat Malafosse R, Penna Ch, Cunha AS, Nordlinger B. Surgical management of hepatic metastases from colorectal malignancies. Ann Oncol 2001;12:887–894.CrossRef Malafosse R, Penna Ch, Cunha AS, Nordlinger B. Surgical management of hepatic metastases from colorectal malignancies. Ann Oncol 2001;12:887–894.CrossRef
6.
Zurück zum Zitat Portier G, Elias D, Bouche O, Rougier P, Bosset JF, Saric J, et al. Multicentric randomized trial of adjuvant fluorouracil and folinic acid compared with surgery alone after resection of colorectal liver metastases: FFCD ACHBTH AURC 9002 trial. J Clin Oncol 2006;24(31):4976–4982.CrossRef Portier G, Elias D, Bouche O, Rougier P, Bosset JF, Saric J, et al. Multicentric randomized trial of adjuvant fluorouracil and folinic acid compared with surgery alone after resection of colorectal liver metastases: FFCD ACHBTH AURC 9002 trial. J Clin Oncol 2006;24(31):4976–4982.CrossRef
7.
Zurück zum Zitat Mitry E, Fields AL, Bleiberg H, Labianca R, Portier G, Tu D, et al. Adjuvant chemotherapy after potentially curative resection of metastases from colorectal cancer: a pooled analysis of two randomized trials. J Clin Oncol 2008;26:4906–4911.CrossRef Mitry E, Fields AL, Bleiberg H, Labianca R, Portier G, Tu D, et al. Adjuvant chemotherapy after potentially curative resection of metastases from colorectal cancer: a pooled analysis of two randomized trials. J Clin Oncol 2008;26:4906–4911.CrossRef
8.
Zurück zum Zitat Pugh RN, Murray-Lyon IM, Dawson JL, Pietroni MC, Williams R. Transection of the oesophagus for bleeding oesophageal varices. Br J Surg 1973;60:646–649.CrossRef Pugh RN, Murray-Lyon IM, Dawson JL, Pietroni MC, Williams R. Transection of the oesophagus for bleeding oesophageal varices. Br J Surg 1973;60:646–649.CrossRef
9.
Zurück zum Zitat Kanemitsu Y, Kato T, Shimizu Y, Inaba Y, Shimada Y, Nakamura K, et al; Colorectal Cancer Study Group (CCSG) of Japan Clinical Oncology Group. A randomized phase II/III trial comparing hepatectomy followed by mFOLFOX6 with hepatectomy alone as treatment for liver metastasis from colorectal cancer: Japan Clinical Oncology Group Study JCOG0603. Jpn J Clin Oncol. 2009 Jun;39(6):406–409.CrossRef Kanemitsu Y, Kato T, Shimizu Y, Inaba Y, Shimada Y, Nakamura K, et al; Colorectal Cancer Study Group (CCSG) of Japan Clinical Oncology Group. A randomized phase II/III trial comparing hepatectomy followed by mFOLFOX6 with hepatectomy alone as treatment for liver metastasis from colorectal cancer: Japan Clinical Oncology Group Study JCOG0603. Jpn J Clin Oncol. 2009 Jun;39(6):406–409.CrossRef
10.
Zurück zum Zitat Welsh FK, Tilney HS, Tekkis PP, John TG, Rees M. Safe liver resection following chemotherapy for colorectal metastases is a matter of timing. Br J Cancer 2007;96:1037–1042.CrossRef Welsh FK, Tilney HS, Tekkis PP, John TG, Rees M. Safe liver resection following chemotherapy for colorectal metastases is a matter of timing. Br J Cancer 2007;96:1037–1042.CrossRef
11.
Zurück zum Zitat Inoue Y, Suzuki Y, Ota M, Fujii K, Kawaguchi N, Shimizu T, et al. Comparison of regeneration of remnant liver after hemihepatectomy with or without the middle hepatic vein. World J Surg 2018;42:1100–1010. Inoue Y, Suzuki Y, Ota M, Fujii K, Kawaguchi N, Shimizu T, et al. Comparison of regeneration of remnant liver after hemihepatectomy with or without the middle hepatic vein. World J Surg 2018;42:1100–1010.
12.
Zurück zum Zitat Inoue Y, Hayashi M, Komeda K, Masubuchi S, Yamamoto M, Yamana H, et al. Resection margin with anatomic or nonanatomic hepatectomy for liver metastasis from colorectal cancer. J Gastrointest Surg 2012;16:1171–1180.CrossRef Inoue Y, Hayashi M, Komeda K, Masubuchi S, Yamamoto M, Yamana H, et al. Resection margin with anatomic or nonanatomic hepatectomy for liver metastasis from colorectal cancer. J Gastrointest Surg 2012;16:1171–1180.CrossRef
13.
Zurück zum Zitat Inoue Y, Imai Y, Osumi W, Shimizu T, Asakuma M, Hirokawa F, et al. What is the optimal timing for liver surgery of resectable synchronous liver metastases from colorectal cancer? Am Surg 2017;83: 45–53. Inoue Y, Imai Y, Osumi W, Shimizu T, Asakuma M, Hirokawa F, et al. What is the optimal timing for liver surgery of resectable synchronous liver metastases from colorectal cancer? Am Surg 2017;83: 45–53.
14.
Zurück zum Zitat Inoue Y, Imai Y, Fujii K, Hirokawa F, Hayashi M, Uchiyama K. The utility of 5-aminolevulinic acid-mediated photodynamic diagnosis in the detection of intraoperative bile leakage. Am J Surg 2017;213:1077–1082. Inoue Y, Imai Y, Fujii K, Hirokawa F, Hayashi M, Uchiyama K. The utility of 5-aminolevulinic acid-mediated photodynamic diagnosis in the detection of intraoperative bile leakage. Am J Surg 2017;213:1077–1082.
15.
Zurück zum Zitat Couinaud C. Surgical anatomy of the liver. Several new aspects [Article in French]. Chirurgie 1986;112:337–342.PubMed Couinaud C. Surgical anatomy of the liver. Several new aspects [Article in French]. Chirurgie 1986;112:337–342.PubMed
16.
Zurück zum Zitat Strasberg SM. Nomenclature of hepatic anatomy and resection: a review of the Brisbane 2000 system. J Hepatobiliary Pancreat Surg 2005;12:351–355.CrossRef Strasberg SM. Nomenclature of hepatic anatomy and resection: a review of the Brisbane 2000 system. J Hepatobiliary Pancreat Surg 2005;12:351–355.CrossRef
17.
Zurück zum Zitat Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 2004;240:205–213.CrossRef Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 2004;240:205–213.CrossRef
18.
Zurück zum Zitat Clavien PA, Barkun J, de Oliveira ML, Vauthey JN, Dindo D, Schulick RD, et al. The Clavien-Dindo classification of surgical complications: five-year experience. Ann Surg 2009;250:187–196.CrossRef Clavien PA, Barkun J, de Oliveira ML, Vauthey JN, Dindo D, Schulick RD, et al. The Clavien-Dindo classification of surgical complications: five-year experience. Ann Surg 2009;250:187–196.CrossRef
19.
Zurück zum Zitat Koch M, Garden J, Padbury R, Rahbari NN, Adam R, Capussotti L, et al. Bile leakage after hepatobiliary and pancreatic surgery: a definition and grading of severity by the International Study Group of Liver Surgery. Surgery 2011;149:680–688.CrossRef Koch M, Garden J, Padbury R, Rahbari NN, Adam R, Capussotti L, et al. Bile leakage after hepatobiliary and pancreatic surgery: a definition and grading of severity by the International Study Group of Liver Surgery. Surgery 2011;149:680–688.CrossRef
20.
Zurück zum Zitat Rahbari NN, Garden OJ, Padbury R, Brooke-Smith M, Crawford M, Adam R, et al. Posthepatectomy liver failure: a definition and grading by the International Study Group of Liver Surgery (ISGLS). Surgery 2011;149:713–724.CrossRef Rahbari NN, Garden OJ, Padbury R, Brooke-Smith M, Crawford M, Adam R, et al. Posthepatectomy liver failure: a definition and grading by the International Study Group of Liver Surgery (ISGLS). Surgery 2011;149:713–724.CrossRef
21.
Zurück zum Zitat Arroyo V, Gines P, Gerbes AL, Dudley FJ, Gentilini P, Laffi G, et al. Definition and diagnostic criteria of refractory ascites and hepatorenal syndrome in cirrhosis. International Ascites Club. Hepatology 1996;23:164–176.PubMed Arroyo V, Gines P, Gerbes AL, Dudley FJ, Gentilini P, Laffi G, et al. Definition and diagnostic criteria of refractory ascites and hepatorenal syndrome in cirrhosis. International Ascites Club. Hepatology 1996;23:164–176.PubMed
22.
Zurück zum Zitat Sobin LH, Gospodarowitz MK, Wittekind C. TNM classification of malignant tumours. 7th ed. New York (NY): Wiley-Blackwell; 2009. Sobin LH, Gospodarowitz MK, Wittekind C. TNM classification of malignant tumours. 7th ed. New York (NY): Wiley-Blackwell; 2009.
23.
Zurück zum Zitat Laurie JA, Moertel CG, Fleming TR, Wieand HS, Leigh JE, Rubin J, et al. Surgical adjuvant therapy of large-bowel carcinoma: an evaluation of levamisole and the combination of levamisole and fluorouracil. The North Central Cancer Treatment Group and the Mayo Clinic. J Clin Oncol. 1989;7:1447–1456.CrossRef Laurie JA, Moertel CG, Fleming TR, Wieand HS, Leigh JE, Rubin J, et al. Surgical adjuvant therapy of large-bowel carcinoma: an evaluation of levamisole and the combination of levamisole and fluorouracil. The North Central Cancer Treatment Group and the Mayo Clinic. J Clin Oncol. 1989;7:1447–1456.CrossRef
24.
Zurück zum Zitat Moertel CG, Fleming TR, Macdonald JS, Haller DG, Laurie JA, Goodman PJ, et al. Levamisole and fluorouracil for adjuvant therapy of resected colon carcinoma. N Engl J Med 1990;322:352–358. Moertel CG, Fleming TR, Macdonald JS, Haller DG, Laurie JA, Goodman PJ, et al. Levamisole and fluorouracil for adjuvant therapy of resected colon carcinoma. N Engl J Med 1990;322:352–358.
25.
Zurück zum Zitat André T, Boni C, Navarro M, Tabernero J, Hickish T, Topham C, et al. Improved overall survival with oxaliplatin, fluorouracil, and leucovorin as adjuvant treatment in stage II or III colon cancer in the MOSAIC trial. J Clin Oncol 2009;27:3109–3116. https://doi.org/10.1200/JCO.2008.20.6771. Epub 2009 May 18. André T, Boni C, Navarro M, Tabernero J, Hickish T, Topham C, et al. Improved overall survival with oxaliplatin, fluorouracil, and leucovorin as adjuvant treatment in stage II or III colon cancer in the MOSAIC trial. J Clin Oncol 2009;27:3109–3116. https://​doi.​org/​10.​1200/​JCO.​2008.​20.​6771. Epub 2009 May 18.
26.
Zurück zum Zitat Schmoll HJ, Cartwright T, Tabernero J, Nowacki MP, Figer A, Maroun J, et al. Phase III trial of capecitabine plus oxaliplatin as adjuvant therapy for stage III colon cancer: a planned safety analysis in 1,864 patients. J Clin Oncol 2007;25:102–109. Schmoll HJ, Cartwright T, Tabernero J, Nowacki MP, Figer A, Maroun J, et al. Phase III trial of capecitabine plus oxaliplatin as adjuvant therapy for stage III colon cancer: a planned safety analysis in 1,864 patients. J Clin Oncol 2007;25:102–109.
27.
Zurück zum Zitat Inoue Y, Fujii K, Tashiro T, Ishii M, Masubuchi S, Yamamoto M, et al. Preoperative chemotherapy may not influence the remnant liver regenerations and outcomes after hepatectomy for colorectal liver metastasis. World J Surg 2018 (in press). Inoue Y, Fujii K, Tashiro T, Ishii M, Masubuchi S, Yamamoto M, et al. Preoperative chemotherapy may not influence the remnant liver regenerations and outcomes after hepatectomy for colorectal liver metastasis. World J Surg 2018 (in press).
Metadaten
Titel
The Relationship Between Postoperative Chemotherapy and Remnant Liver Regeneration and Outcomes After Hepatectomy for Colorectal Liver Metastasis
verfasst von
Yoshihiro Inoue
Kensuke Fujii
Masatsugu Ishii
Syuji Kagota
Hiroki Hamamoto
Wataru Osumi
Tetsuji Terasawa
Yusuke Tsuchimoto
Shinsuke Masubuchi
Masashi Yamamoto
Akira Asai
Koji Komeda
Shinya Fukunishi
Fumitoshi Hirokawa
Masahiro Goto
Yoshihumi Narumi
Kazuhide Higuchi
Kazuhisa Uchiyama
Publikationsdatum
05.09.2018
Verlag
Springer US
Erschienen in
Journal of Gastrointestinal Surgery / Ausgabe 10/2019
Print ISSN: 1091-255X
Elektronische ISSN: 1873-4626
DOI
https://doi.org/10.1007/s11605-018-3952-1

Weitere Artikel der Ausgabe 10/2019

Journal of Gastrointestinal Surgery 10/2019 Zur Ausgabe

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

CME: 2 Punkte

Prof. Dr. med. Gregor Antoniadis Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

CME: 2 Punkte

Dr. med. Benjamin Meyknecht, PD Dr. med. Oliver Pieske Das Webinar S2e-Leitlinie „Distale Radiusfraktur“ beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

CME: 2 Punkte

Dr. med. Mihailo Andric
Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.