Hepatectomy and liver regeneration in the results of treatment of colorectal liver metastasis

Yoshihiro Inoue; Masatsugu Ishii; Keisuke Yokohama; Hideko Ohama; Yusuke Tsuchimoto; Tetsuji Terazawa; Akira Asai; Shinya Fukunishi; Kazuhide Higuchi; Kazuhisa Uchiyama

doi:10.5114/wo.2020.100272

eISSN: 1897-4309
ISSN: 1428-2526

Contemporary Oncology/Współczesna Onkologia

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3/2020
vol. 24

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abstract:

Original paper

Hepatectomy and liver regeneration in the results of treatment of colorectal liver metastasis

Yoshihiro Inoue

^{1, 2}

,

Masatsugu Ishii

^{1, 2}

,

Keisuke Yokohama

³

,

Hideko Ohama

³

,

Yusuke Tsuchimoto

³

,

Tetsuji Terazawa

³

,

Akira Asai

³

,

Shinya Fukunishi

³

,

Kazuhide Higuchi

³

,

Kazuhisa Uchiyama

^{1, 2}

Department of General and Gastroenterological Surgery, Osaka Medical College Hospital, Takatsuki City, Osaka, Japan
Department of General and Gastroenterological Surgery, Osaka Medical College Mishima-Minami Hospital, Takatsuki City, Osaka, Japan
Second Department of Internal Medicine, Osaka Medical College Hospital, Takatsuki City, Osaka, Japan

Contemp Oncol (Pozn) 2020; 24 (3): 172–176

DOI: https://doi.org/10.5114/wo.2020.100272

Online publish date: 2020/10/30

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Introduction
Hepatectomy is currently the most reliable treatment modality for colorectal liver metastases (CRLM). This paper describes and discusses the outcomes of initial versus repeat hepatic resection for CRLM.

Material and methods
Between January 2008 and December 2018, we retrospectively analyzed the data of 385 patients who underwent initial and repeat hepatic resection for CRLM at a single institution with respect to surgical outcomes and remnant liver regeneration. The remnant liver volume was postoperatively measured via computed tomography on postoperative day 7 and at 1, 2, 5, 12, and 24 months postoperatively.

Results
The liver regeneration rate peaked at 1 week postoperatively, and gradually decreased thereafter. Remnant liver volume plateaued around 1–2 months postoperatively, when regeneration was almost complete. There was no difference in the rate of liver volume regeneration during the entire postoperative period between initial and repeat hepatic resection (p = 0.708, 0.511, 0.055, 0.053, 0.102, and 0.110, respectively). After 2 months postoperatively, the laboratory data showed recovery toward near normal levels, and none of the data exhibited significant differences. There were also no significant differences in morbidity rate, mortality rate, overall survival, and recurrence-free survival after hepatic resection (p = 0.488, 0.124, 0.071 and 0.387, respectively).

Conclusions
Initial and repeat hepatectomy showed similar outcomes of remnant liver regeneration and short- and long-term prognoses.

keywords:

Hepatectomy and liver regeneration in the results of treatment of colorectal liver metastasis

Yoshihiro Inoue 1, 2 , Masatsugu Ishii 1, 2 , Keisuke Yokohama 3 , Hideko Ohama 3 , Yusuke Tsuchimoto 3 , Tetsuji Terazawa 3 , Akira Asai 3 , Shinya Fukunishi 3 , Kazuhide Higuchi 3 , Kazuhisa Uchiyama 1, 2

initial hepatic resection, repeat hepatic resection, remnant liver regeneration, prognosis

Yoshihiro Inoue

^{1, 2}

,

Masatsugu Ishii

^{1, 2}

,

Keisuke Yokohama

³

,

Hideko Ohama

³

,

Yusuke Tsuchimoto

³

,

Tetsuji Terazawa

³

,

Akira Asai

³

,

Shinya Fukunishi

³

,

Kazuhide Higuchi

³

,

Kazuhisa Uchiyama

^{1, 2}