title: Limiting factors for liver regeneration after a major hepatic resection for colorectal cancer metastases.
abstract: BACKGROUND
  Chemotherapy before resection of colorectal metastases in the liver is extensively used and has been shown to induce histopathological changes in the liver parenchyma, although little is known about the effect of chemotherapy on liver regeneration. The aim of this study was to determine if pre-operative chemotherapy influences the regenerated liver volume after a major liver resection.
  
  
  METHODS
  This retrospective cohort study included 74 patients subjected to a major liver resection for colorectal metastases. Patients were divided into two groups depending on whether they had been treated with chemotherapy less than 3 months before surgery or not. Liver volumes were measured before and 1 year after resection.
  
  
  RESULTS
  Pre-operative chemotherapy reduced volumetric liver regeneration (83 ± 2% versus 91 ± 2%; P = 0.007) as compared with patients without chemotherapy. There was a linear correlation between regenerated volume and time interval between the end of chemotherapy to resection (P = 0.031).
  
  
  CONCLUSIONS
  Pre-operative chemotherapy in patients with colorectal liver metastases negatively affects volume regeneration after a partial hepatectomy. The time interval between chemotherapy and surgery determines the impact of these affects.
authors: Department of Surgery, Clinical Sciences Lund, Lund University, Skåne University Hospital, Lund, Sweden. christian.sturesson@med.lu.se
authors: Christian
authors: C
authors: Sturesson
authors: Jan
authors: J
authors: Nilsson
authors: Sam
authors: S
authors: Eriksson
authors: Lidewij
authors: L
authors: Spelt
authors: Roland
authors: R
authors: Andersson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D015179:Colorectal Neoplasms / Q000473:pathology*; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects*; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary* / Q000601:surgery*; D008115:Liver Regeneration / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009929:Organ Size; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome