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World Journal of Surgery
Published in: World Journal of Surgery 4/2017

01-04-2017 | Original Scientific Report

Hepatectomy for Colorectal Cancer Liver Metastases in the Era of Modern Preoperative Chemotherapy: Evaluation of Postoperative Complications

Authors: Kengo Fukuoka, Satoshi Nara, Yoshitaka Honma, Yoji Kishi, Minoru Esaki, Kazuaki Shimada

Published in: World Journal of Surgery | Issue 4/2017

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Abstract

Background

Recently, an increasing number of patients with liver metastases from colorectal cancer have received chemotherapy before hepatectomy. However, the effect of chemotherapy on postoperative short-term outcome is not well defined.

Methods

We retrospectively investigated the postoperative complications of 439 patients who underwent hepatectomy for colorectal liver metastases in our division from 2005 to 2014. Patients were classified into two groups according to the presence (Cx; 84 patients) or absence (NCx; 355 patients) of preoperative chemotherapy. Univariate and multivariate analyses were conducted to determine the predictive factors for postoperative complications.

Results

There was neither mortality nor liver failure after surgery. There was no significant difference in the frequency of postoperative complications between Groups Cx and NCx [29 vs 26 % for all complications; both 6 % for bile leakage that required therapeutic intervention; and 2 vs 3 % for Clavien–Dindo (CD) Grade ≥ IIIa, respectively]. In Group Cx, morbidity rates were similar among patients with different chemotherapy regimens. Chemotherapy-related factors (administration of bevacizumab, oxaliplatin or irinotecan, duration of chemotherapy >150 days, and timing of hepatectomy) were not significantly associated with clinically relevant bile leakage and CD ≥ IIIa in multivariate analysis.

Conclusion

Even after combination chemotherapy including targeted therapy, hepatectomy for colorectal liver metastases can be performed safely without increasing morbidity or mortality, if the patients fulfill the conventional criteria for surgery.
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Metadata
Title
Hepatectomy for Colorectal Cancer Liver Metastases in the Era of Modern Preoperative Chemotherapy: Evaluation of Postoperative Complications
Authors
Kengo Fukuoka
Satoshi Nara
Yoshitaka Honma
Yoji Kishi
Minoru Esaki
Kazuaki Shimada
Publication date
01-04-2017
Publisher
Springer International Publishing
Published in
World Journal of Surgery / Issue 4/2017
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-016-3724-6

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