新辅助化疗不会损害在对结直肠癌肝转移灶进行肝切除或门静脉栓塞后肝脏的再生能力。
Neoadjuvant chemotherapy does not impair liver regeneration following hepatectomy or portal vein embolization for colorectal cancer liver metastases.
作者信息
Simoneau Eve, Alanazi Reema, Alshenaifi Jumanah, Molla Nouran, Aljiffry Murad, Medkhali Ahmad, Boucher Louis-Martin, Asselah Jamil, Metrakos Peter, Hassanain Mazen
机构信息
Department of Surgery, McGill University, Montreal, Canada.
Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
出版信息
J Surg Oncol. 2016 Mar;113(4):449-55. doi: 10.1002/jso.24139. Epub 2016 Mar 9.
BACKGROUND AND OBJECTIVES
Treatment strategies for colorectal cancer liver metastasis (CRCLM) such as major hepatectomy and portal vein embolization (PVE) rely on liver regeneration. We aim to investigate the effect of neoadjuvant chemotherapy on liver regeneration occurring after PVE and after major hepatectomy.
METHODS
CRCLM patients undergoing PVE or major resection were identified retrospectively from our database. Liver regeneration data (expressed as future liver remnant [FLR] and percentage of liver regeneration [%LR]), total liver volume (TLV) and clinical characteristics were collected.
RESULTS
Between 2003 and 2013, 226 patients were included (85 major resection, 141 PVE). The median chemotherapy cycles was six in both groups. The median time interval between the last chemotherapy and the intervention was 51 days in the PVE group and 79 days in the hepatectomy group. In the PVE group, chemotherapy was not associated with altered liver regeneration (number of cycles [P = 0.435], timing [P = 0.563], or chemotherapy agent [P = 0.116]). Similarly in the major hepatectomy group, preoperative chemotherapy (number of cycles [P = 0.114]; agent [P = 0.061], timing [P = 0.126]) were not significantly associated with differences in liver regeneration (P = 0.592). In both groups, the predicted FLR% was inversely correlated with the %LR (P < 0.001).
CONCLUSION
Chemotherapy does not affect liver regeneration following PVE or major resection. J. Surg. Oncol. 2016;113:449-455. © 2016 Wiley Periodicals, Inc.
背景与目的
结直肠癌肝转移（CRCLM）的治疗策略，如扩大肝切除术和门静脉栓塞术（PVE），均依赖于肝脏再生。我们旨在研究新辅助化疗对PVE后及扩大肝切除术后肝脏再生的影响。
方法
从我们的数据库中回顾性识别接受PVE或扩大切除术的CRCLM患者。收集肝脏再生数据（以未来肝脏残余量[FLR]和肝脏再生百分比[%LR]表示）、全肝体积（TLV）及临床特征。
结果
2003年至2013年期间，共纳入226例患者（85例行扩大切除术，141例行PVE）。两组的化疗周期中位数均为6个周期。PVE组最后一次化疗与干预之间的中位时间间隔为51天，肝切除组为79天。在PVE组中，化疗与肝脏再生改变无关（化疗周期数[P = 0.435]、时间[P = 0.563]或化疗药物[P = 0.116]）。同样，在扩大肝切除组中，术前化疗（化疗周期数[P = 0.114]；药物[P = 0.061]、时间[P = 0.126]）与肝脏再生差异无显著相关性（P = 0.592）。在两组中，预测的FLR%与%LR呈负相关（P < 0.001）。
结论
化疗不影响PVE或扩大切除术后的肝脏再生。《外科肿瘤学杂志》2016年；113:449 - 455。©2016威利期刊公司
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