Preoperative Chemotherapy on Functional Liver Regeneration for Colorectal Liver Metastases Assessed With 99mTc-GSA SPECT/CT Imaging
| Autor: | Daisuke Hashimoto, Akira Chikamoto, Shigeki Nakagawa, Toru Beppu, Takatoshi Ishiko, Katsunori Imai, Toshiro Masuda, Shinya Shiraishi, Morikatsu Yoshida, Takaaki Higashi, Hirohisa Okabe, Hiromitsu Hayashi, Hidetoshi Nitta, Tatsunori Miyata, Yasuyuki Yamashita, Hideo Baba, Yuji Miyamoto |
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| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
Chemotherapy medicine.diagnostic_test 99mtc gsa business.industry medicine.medical_treatment Single-photon emission computed tomography Scintigraphy medicine.disease Liver regeneration 03 medical and health sciences 0302 clinical medicine 030220 oncology & carcinogenesis medicine Preoperative chemotherapy 030211 gastroenterology & hepatology Surgery Radiology business Viral hepatitis Emission computed tomography |
| Zdroj: | International Surgery. 102:431-439 |
| ISSN: | 2520-2456 0020-8868 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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