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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 10/2010

01-10-2010 | Hepatobiliary Tumors

Recovery of Liver Function After the Cessation of Preoperative Chemotherapy for Colorectal Liver Metastasis

Authors: Takeshi Takamoto, MD, Takuya Hashimoto, MD, PhD, Keiji Sano, MD, PhD, Yoshikazu Maruyama, MD, Kazuto Inoue, MD, PhD, Satoshi Ogata, MD, PhD, Tamiko Takemura, MD, PhD, Norihiro Kokudo, MD, PhD, Masatoshi Makuuchi, MD, PhD

Published in: Annals of Surgical Oncology | Issue 10/2010

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Abstract

Background

Preoperative chemotherapy containing oxaliplatin (FOLFOX) or irinotecan (FOLFIRI) causes histological liver injury and increases postoperative morbidity and mortality in patients with colorectal liver metastasis (CRLM). However, information on the aggravation of liver function and its reversibility is scarce.

Methods

A total of 55 patients who underwent a hepatectomy after receiving FOLFOX and/or FOLFIRI were included in the present study. Indocyanine green tests were repeatedly performed before hepatectomy for monitoring the change of hepatic functional reserve.

Results

A significant decrement in the ICG R15 value was observed at 2–4 weeks (12.9%, P = .04), 4–8 weeks (11.4%, P = .01), and 8 or more weeks (11.1%, P = .006) after the last chemotherapy, compared with results documented within 2 weeks (16.8%). However, no significant change was observed among the values obtained at 2–4 weeks, 4–8 weeks, and 8 or more weeks. The individual ICG R15 values at the beginning and end of the cessation period also improved from 17.7% to 11.6% (P = .001). Histological liver injury was associated with larger amounts of operative blood loss but not with morbidity. Neither liver failure nor mortality occurred in the present series.

Conclusions

The hepatic functional reserve, represented by the ICG R15 value, improves during the period after chemotherapy cessation. The present study suggests that chemotherapy cessation for at least 2–4 weeks enables an improvement in the hepatic functional reserve, especially among patients with an abnormal ICG R15 value (> 10%) who have received 6 or more cycles of FOLFOX and/or FOLFIRI.
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Metadata
Title
Recovery of Liver Function After the Cessation of Preoperative Chemotherapy for Colorectal Liver Metastasis
Authors
Takeshi Takamoto, MD
Takuya Hashimoto, MD, PhD
Keiji Sano, MD, PhD
Yoshikazu Maruyama, MD
Kazuto Inoue, MD, PhD
Satoshi Ogata, MD, PhD
Tamiko Takemura, MD, PhD
Norihiro Kokudo, MD, PhD
Masatoshi Makuuchi, MD, PhD
Publication date
01-10-2010
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 10/2010
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-010-1074-4

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