scholarly journals Nodular Regenerative Hyperplasia Secondary to Neoadjuvant Chemotherapy for Colorectal Liver Metastases

2009 ◽  
Vol 2009 ◽  
pp. 1-4 ◽  
Author(s):  
Maartje A. J. van den Broek ◽  
Steven W. M. Olde Damink ◽  
Ann Driessen ◽  
Cornelis H. C. Dejong ◽  
Marc H. A. Bemelmans
Keyword(s):  
Neoadjuvant Chemotherapy ◽  
Liver Metastases ◽  
Colorectal Liver Metastases ◽  
Harmful Effect ◽  
Liver Volume ◽  
Volumetric Analysis ◽  
Nodular Regenerative Hyperplasia ◽  
Remnant Liver ◽  
Operative Strategy ◽  
Liver Specimen

Liver resection is the only curative treatment for patients with colorectal liver metastases (CLMs). Neoadjuvant chemotherapy can improve resectability but has a potential harmful effect on the nontumorous liver. Patients with chemotherapy-induced hepatic injury undergoing liver surgery have higher risks of post-resectional morbidity. We present two cases of patients without pre-existent liver disease treated with oxaliplatin-based chemotherapy followed by surgical resection of their CLMs. Their intra-operative liver specimen showed morphologic abnormalities characteristic of nodular regenerative hyperplasia (NRH). NRH led to portal hypertension in both patients that resulted in deleterious post-resectional complications and death of one patient. Interestingly, the other patient underwent two repeat nonanatomic liver resections because of recurrent CLMs. The intra-operative liver specimen still showed signs of NRH and sinusoidal congestion, but the post-resectional courses were uneventful. Nevertheless, caution is recommended in patients with suspected NRH. Careful volumetric analysis should guide the operative strategy. When future remnant liver volume is regarded insufficient, portal vein embolization or restrictive surgery should be considered.

scholarly journals Preoperative Chemotherapy on Functional Liver Regeneration for Colorectal Liver Metastases Assessed With 99mTc-GSA SPECT/CT Imaging

2018 ◽  
Vol 102 (9-10) ◽  
pp. 431-439 ◽  
Author(s):  
Toru Beppu ◽  
Hiromitsu Hayashi ◽  
Morikatsu Yoshida ◽  
Hidetoshi Nitta ◽  
Katsunori Imai ◽  
...  
Keyword(s):  
Liver Resection ◽  
Liver Metastases ◽  
Liver Regeneration ◽  
Preoperative Chemotherapy ◽  
Colorectal Liver Metastases ◽  
Major Hepatectomy ◽  
Liver Volume ◽  
Control Group ◽  
Remnant Liver ◽  
Resection Rate

Objective: To investigate the functional liver regeneration after chemotherapy and liver resection for colorectal liver metastases (CRLM). Background/Purpose: Preoperative chemotherapy followed by liver resection for CRLM has been increasing; however, its negative impact on liver regeneration remains unknown. Methods: From January 2009 to December 2013, we enrolled 40 selected patients who underwent major hepatectomy without viral hepatitis and severe liver fibrosis. CRLM patients with preoperative chemotherapy (CT-CRLM group, n = 12) and patients without preoperative chemotherapy (control group, n = 28) were evaluated. Liver volume (LV) and functional liver volume (FLV) was assessed using Tc-99m–labeled galactosyl human serum albumin (99mTc-GSA) scintigraphy, single-photon emission computed tomography (SPECT), CT-fused images. Preoperative, future remnant liver, and post 1-month values were compared. Results: Median course of preoperative chemotherapy was 8 (range: 6–16). Preoperative background factors were almost identical including resection rate and functional resection rate. In the CT-CRLM group and in the control group, the percentage increases in LV were 39.3% ± 29.0% and 23.2% ± 23.5% (P = 0.037), and FLV were 79.4% ± 43.1% and 57.0% ± 33.4% (P = 0.417), respectively; absolute differences in LV were 216.2 ± 155.7 cm3 and 148.7 ± 134.7 cm3 (P = 0.086) and FLV were 19.4% ± 8.5%/m2 and 17.4% ± 7.9%/m2 (P = 0.235), respectively. We found no obvious tendency for negative influence on liver functional regeneration by the preoperative regimens for CRLM. Conclusions: Several courses of preoperative chemotherapy may not affect functional liver regeneration for CRLM patients after major hepatectomy.

Does conversion chemotherapy really improve survival in patients with colorectal liver metastases?

2013 ◽  
Vol 31 (4_suppl) ◽  
pp. 435-435
Author(s):  
Kozo Kataoka ◽  
Akiyoshi Kanazawa ◽  
Shigeyoshi Iwamoto ◽  
Yasuhiro Miyake ◽  
Takeshi Kato ◽  
...  
Keyword(s):  
Liver Resection ◽  
Liver Metastases ◽  
Hepatic Resection ◽  
Colorectal Liver Metastases ◽  
Liver Volume ◽  
Hepatic Metastases ◽  
Disease Free Survival ◽  
R0 Resection ◽  
Remnant Liver ◽  
Unresectable Colorectal Liver Metastases

435 Background: Recently, liver resection becomes possible by intensive chemotherapy, i.e. conversion chemotherapy, in patients with initially unresectable colorectal liver metastases (CLM). But the criteria for non-resectability varies one team to another, and there are few reports about the clinical benefit of conversion chemotherapy followed by liver resection. Methods: Our criteria for resectability of CLM depends on the size of remnant liver volume (>30%) and expected function after the removal of all metastases, regardress of number and size of CLM. From December 2007 to September 2011, 113 patients were diagnosed as CLM without extra-hepatic metastases and received chemotherapy. 47 patients were initially diagnosed as resectable and received hepatic resection after chemotherapy (resected group). 66 patients were initially diagnosed as unresectable, but 11 patients become resectable after chemotherapy (conversion group) and 55 patients remain unresectable in spite of chemotherapy (unresecetd group). We assessed the survival benefit between these 3 groups, retrospectively. Results: 110 patients received oxaliplatin-based regimen and 3 irrinotecan-based regimen. In coversion group, 8 patients received cetuximab containing regimen and 2 received bevacizumab containing regimen. 46 of 47 patients in resected group received R0 resection and 7 of 11 patients in conversion group. No serious postoperative complications were observed in resected and conversion group, but the incidence of a surgical site infection in conversion group was somewhat higher than in resected group. Median disease-free survival was significantly higher in the resected group than conversion group (16.73 months [95% CI: 7.80~25.47] and 3.83 months [95% CI: 0.35~7.31 months]) (P=0.031). And median overall survival (OS) was also higher in resected group, but not significant. In resected and conversion group, median OS was significantly higher than in unresected group. (52.20 vs 39.37 vs 20.57 months (p <0.001)). Conclusions: The recurrence rate was higher in coversion group, but conversion chemotherapy followed by hepatic resection seems to be promising and feasible strategy in initially unresectable CLM patients.

Survival benefit of neoadjuvant chemotherapy and surgery versus surgery first for resectable colorectal liver metastases: a cohort study

2021 ◽  
Author(s):  
Corina Behrenbruch ◽  
Sowmya Prabhakaran ◽  
Dilshan Udayasiri ◽  
Frédéric Hollande ◽  
Michael Michael ◽  
...  
Keyword(s):  
Cohort Study ◽  
Neoadjuvant Chemotherapy ◽  
Liver Metastases ◽  
Survival Benefit ◽  
Colorectal Liver Metastases ◽  
Surgery First

The pathological response to neoadjuvant chemotherapy with FOLFOX-4 for colorectal liver metastases: a comparative study

2007 ◽  
Vol 451 (5) ◽  
pp. 943-948 ◽  
Author(s):  
Mark M. Aloysius ◽  
Abed M. Zaitoun ◽  
Ian J. Beckingham ◽  
Keith R. Neal ◽  
Guruprasad P. Aithal ◽  
...  
Keyword(s):  
Neoadjuvant Chemotherapy ◽  
Comparative Study ◽  
Liver Metastases ◽  
Colorectal Liver Metastases ◽  
Pathological Response ◽  
Response To Neoadjuvant Chemotherapy

scholarly journals Remnant Liver Ischemia as a Prognostic Factor for Cancer-Specific Survival After Resection of Colorectal Liver Metastases

JAMA Surgery ◽  
2017 ◽  
Vol 152 (10) ◽  
pp. e172986 ◽  
Author(s):  
Suguru Yamashita ◽  
Aradhana M. Venkatesan ◽  
Takashi Mizuno ◽  
Thomas A. Aloia ◽  
Yun S. Chun ◽  
...  
Keyword(s):  
Prognostic Factor ◽  
Liver Metastases ◽  
Colorectal Liver Metastases ◽  
Remnant Liver ◽  
Liver Ischemia ◽  
Cancer Specific Survival

scholarly journals Impact of Neoadjuvant Chemotherapy on Clinical Risk Scores and Survival in Patients with Colorectal Liver Metastases

2016 ◽  
Vol 24 (1) ◽  
pp. 236-243 ◽  
Author(s):  
Kerstin Wimmer ◽  
Christoph Schwarz ◽  
Carmen Szabo ◽  
Martin Bodingbauer ◽  
Dietmar Tamandl ◽  
...  
Keyword(s):  
Neoadjuvant Chemotherapy ◽  
Liver Metastases ◽  
Colorectal Liver Metastases ◽  
Risk Scores ◽  
Clinical Risk
Sign in / Sign up

Export Citation Format

Share Document