title: Effect of preoperative chemotherapy on postoperative liver regeneration following hepatic resection as estimated by liver volume.
abstract: BACKGROUND
  In order to analyze postoperative liver regeneration following hepatic resection after chemotherapy, we retrospectively investigated the differences in liver regeneration by comparing changes of residual liver volume in three groups: a living liver donor group and two groups of patients with colorectal liver metastases who did and did not undergo preoperative chemotherapy.
  
  
  METHODS
  This study included 32 patients who had at least segmental anatomical hepatic resection. Residual liver volume, early postoperative liver volume, and late postoperative liver volume were calculated to study the changes over time. From the histopathological analysis of chemotherapy-induced liver disorders, the effect on liver regeneration according to the histopathology of noncancerous liver tissue was also compared between the two colorectal cancer groups using Kleiner's score for steatohepatitis grading {Hepatology, 41(6):1313-1321, 2005} and sinusoidal obstruction syndrome (SOS) grading for sinusoidal obstructions {Ann Oncol, 15(3):460-466, 2004}.
  
  
  RESULTS
  Assuming a preoperative liver volume of 100%, mean late postoperative liver volumes in the three groups (the living liver donor group and the colorectal cancer groups with or without chemotherapy) were 91.1%, 80.8%, and 81.3%, respectively, with about the same rate of liver regeneration among the three groups. Histopathological analysis revealed no correlation between either the Kleiner's scores or the SOS grading and liver regeneration.
  
  
  CONCLUSIONS
  As estimated by liver volume, the level of liver regeneration was the same in normal livers, tumor-bearing livers, and post-chemotherapy tumor-bearing livers. Liver regeneration was not adversely affected by the extent to which steatosis or sinusoidal dilatation was induced in noncancerous tissue by chemotherapy in patients scheduled for surgery.
authors.affiliation: Department of Surgery, Iwate Medical University, 19-1 Uchimaru, Morioka, 020-8505, Japan.
authors.forename: Daiki
authors.initials: D
authors.lastname: Takeda
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Nitta
authors.forename: Takeshi
authors.initials: T
authors.lastname: Takahara
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Hasegawa
authors.forename: Naoko
authors.initials: N
authors.lastname: Itou
authors.forename: Go
authors.initials: G
authors.lastname: Wakabayashi
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D003131:Combined Modality Therapy; D005234:Fatty Liver / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy; D006504:Hepatic Veno-Occlusive Disease / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D006801:Humans; D008099:Liver / Q000473:pathology*; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000556:secondary / Q000601:surgery; D008115:Liver Regeneration; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011184:Postoperative Period; D011300:Preoperative Care; D011379:Prognosis; D012189:Retrospective Studies; D055815:Young Adult