Preoperative Chemotherapy May Not Influence the Remnant Liver Regenerations and Outcomes After Hepatectomy for Colorectal Liver Metastasis

A 72-year-old woman with a sigmoid colon cancer anda synchronous colorectal liver metastasis (CRLM), whichinvolved the right hepatic vein (RHV) and the inferiorvena cava (IVC), was referred to our hospital. Themetastatic lesion was diagnosed as initially unresectablebecause of its invasion into the confluence of theRHV and IVC. After she had undergone laparoscopicsigmoidectomy for the original tumor, she consequentlyhad 3 courses of modified 5-fluorouracil, leucovorin,and oxaliplatin (mFOLFOX6) plus cetuximab. Computedtomography revealed a partial response, and theconfluence of the RHV and IVC got free from cancerinvasion. After 3 additional courses of mFOLFOX6 pluscetuximab, preoperative percutaneous transhepaticportal vein embolization (PTPE) was performed tosecure the future remnant liver volume. Finally, a righthemihepatectomy was performed. The postoperativecourse was uneventful. The patient was dischargedfrom the hospital on postoperative day 13. She hadneither local recurrence nor distant metastasis 18 moafter the last surgical intervention. This multidisciplinarystrategy, consisting of conversion chemotherapy usingFOLFOX plus cetuximab and PTPE, could contributein facilitating curative hepatic resection for initiallyunresectable CRLM.Key words: Initially unresectable; Colorectal liver metastasis;Conversion chemotherapy; Cetuximab; Percutaneoustranshepatic portal vein embolization

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Extended preoperative chemotherapy, extent of liver resection and blood transfusion are predictive factors of liver failure following resection of colorectal liver metastasis

European Journal of Surgical Oncology ◽

10.1016/j.ejso.2012.12.020 ◽

2013 ◽

Vol 39 (4) ◽

pp. 380-385 ◽

Cited By ~ 30

Author(s):

H.S.C. Ribeiro ◽

W.L. Costa ◽

A.L. Diniz ◽

A.L. Godoy ◽

P. Herman ◽

...

Keyword(s):

Liver Resection ◽

Liver Metastasis ◽

Blood Transfusion ◽

Liver Failure ◽

Preoperative Chemotherapy ◽

Predictive Factors ◽

Colorectal Liver Metastasis

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Imaging in resectable colorectal liver metastasis patients with or without preoperative chemotherapy: results of the PROMETEO-01 study

British Journal of Cancer ◽

10.1038/bjc.2014.351 ◽

2014 ◽

Vol 111 (4) ◽

pp. 667-673 ◽

Cited By ~ 24

Author(s):

F L Rojas Llimpe ◽

F Di Fabio ◽

G Ercolani ◽

E Giampalma ◽

A Cappelli ◽

...

Keyword(s):

Liver Metastasis ◽

Preoperative Chemotherapy ◽

Colorectal Liver Metastasis

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Darbepoetin-α Promotes Cell Proliferation in Established Extrahepatic Colorectal Tumors after Major Hepatectomy

European Surgical Research ◽

10.1159/000442384 ◽

2015 ◽

Vol 56 (1-2) ◽

pp. 49-60

Author(s):

Sebastian Senger ◽

Otto Kollmar ◽

Michael D. Menger ◽

Kathrin Rupertus

Keyword(s):

Cell Proliferation ◽

Cell Migration ◽

Liver Metastasis ◽

Tumor Cell ◽

Colorectal Liver Metastasis ◽

Major Hepatectomy ◽

Colorectal Metastases ◽

Remnant Liver ◽

Tumor Cell Proliferation ◽

Tumor Cell Migration

Background: The glycoprotein hormone erythropoietin and its analogue darbepoetin-α (DPO) have been shown to reduce the risk of acute liver failure after major hepatectomy. However, previous experimental studies have also shown that DPO significantly enhances neovascularization and tumor cell proliferation in established colorectal liver metastasis in hepatectomized and nonhepatectomized mice. The present study now analyzes whether DPO influences cell proliferation and migration as well as vascularization and growth of established colorectal metastasis at extrahepatic sites after major hepatectomy. Methods: GFP-transfected CT26.WT colorectal cancer cells were implanted into dorsal skinfold chambers of syngeneic BALB/c mice. Five days after tumor cell implantation, the animals received a single dose of DPO (10 µg/kg body weight) or phosphate-buffered saline solution (PBS) intravenously. Additional animals received a 70% hepatectomy and DPO or PBS treatment. Tumor vascularization and growth as well as tumor cell migration, proliferation and apoptosis were studied repetitively over 14 days using intravital fluorescence microscopy, histology and immunohistochemistry. Results: DPO did not influence tumor cell migration and apoptosis. In addition, DPO did not stimulate tumor cell infiltration or vascularization; however, significantly increased tumor cell proliferation was detected in hepatectomized animals. Conclusion: DPO increases cell proliferation in established extrahepatic colorectal metastases after major hepatectomy. Thus, DPO may not be recommended to stimulate regeneration of the remnant liver after major hepatectomy for colorectal liver metastasis.

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