title: Neoadjuvant chemotherapy does not impair liver regeneration following hepatectomy or portal vein embolization for colorectal cancer liver metastases.
abstract: OBJECTIVE
  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).
  
  
  CONCLUSIONS
  Chemotherapy does not affect liver regeneration following PVE or major resection. J. Surg. Oncol. 2016;113:449-455. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Department of Surgery, McGill University, Montreal, Canada.
authors.forename: Eve
authors.initials: E
authors.lastname: Simoneau
authors.affiliation: Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Reema
authors.initials: R
authors.lastname: Alanazi
authors.affiliation: Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Jumanah
authors.initials: J
authors.lastname: Alshenaifi
authors.affiliation: Department of Radiology, McGill University, Montreal, Canada.
authors.forename: Nouran
authors.initials: N
authors.lastname: Molla
authors.affiliation: Department of Surgery, College of Medicine King Abdulaziz University, Jeddah, Saudi Arabia.
authors.forename: Murad
authors.initials: M
authors.lastname: Aljiffry
authors.affiliation: Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Ahmad
authors.initials: A
authors.lastname: Medkhali
authors.affiliation: Department of Radiology, McGill University, Montreal, Canada.
authors.forename: Louis-Martin
authors.initials: LM
authors.lastname: Boucher
authors.affiliation: Department of Oncology, McGill University, Montreal, Canada.
authors.forename: Jamil
authors.initials: J
authors.lastname: Asselah
authors.affiliation: Department of Surgery, McGill University, Montreal, Canada.
authors.forename: Peter
authors.initials: P
authors.lastname: Metrakos
authors.affiliation: Department of Surgery, McGill University, Montreal, Canada.|Department of Oncology, McGill University, Montreal, Canada.
authors.forename: Mazen
authors.initials: M
authors.lastname: Hassanain
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D016461:Chemoembolization, Therapeutic / Q000379:methods; D017024:Chemotherapy, Adjuvant; D015179:Colorectal Neoplasms / Q000473:pathology; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy / Q000556:secondary* / Q000601:surgery / Q000628:therapy*; D008115:Liver Regeneration / Q000187:drug effects*; D008297:Male; D020360:Neoadjuvant Therapy; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D000077150:Oxaliplatin; D011169:Portal Vein; D012189:Retrospective Studies
chemical_list: D009944:Organoplatinum Compounds; D000077150:Oxaliplatin
keywords: PVE; chemotherapy; colorectal cancer liver metastases; hepatectomy; liver regeneration