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Chemotherapy Between the First and Second Stages of a Two-Stage Hepatectomy for Colorectal Liver Metastases: Should We Routinely Recommend It?

  • Hepatobiliary Tumors
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

The aim of the present study is to examine the effect of systemic chemotherapy after the 1st-stage hepatectomy (CT×2) on the progression of disease and dropout rates. A major pitfall of the 2-stage hepatectomy procedure is a high dropout rate after the 1st-stage hepatectomy due to progression of disease (PD). Routine use of CT×2 has been advocated.

Methods

A total of 47 patients with multiple, bilateral unresectable liver metastases were selected for a 2-stage hepatectomy procedure (±portal vein occlusion).

Results

Of the total, 37 patients (78.7%) underwent systemic chemotherapy before the 1st-stage hepatectomy (CT×1) and 25 patients (53.2%) underwent CT×2; PD was significantly more common during CT×2 than during CT×1 (P = .002). Of the 47 patients planned for the 2nd-stage hepatectomy, 36 (76.6%) completed the procedure. Of these 47 patients, 25 (53.2%) showed PD after the 1st-stage hepatectomy, 12 in the CT×2 group and 13 in the no-CT×2 group; administration of CT×2 did not significantly affect the PD rate (P = .561). The overall dropout rate was 23.4% (n = 11 patients): 16% in the CT×2 group vs. 31.8% in the no-CT×2 group (P = .303).

Conclusions

The routine use of chemotherapy between the 1st- and 2nd-stage hepatectomy does not guarantee lower PD and dropout rates.

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Authors and Affiliations

  1. Department of Surgical Oncology, Istituto per la Ricerca e la Cura del Cancro, Candiolo, Turin, Italy

    Andrea Muratore MD & Alfredo Mellano MD

  2. Department of Digestive and Hepatobiliary-Surgery, Ospedale Mauriziano “Umberto I”, Turin, Italy

    Giuseppe Zimmitti MD, Dario Ribero MD, Luca Viganò MD & Lorenzo Capussotti MD

Authors
  1. Andrea Muratore MD
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  2. Giuseppe Zimmitti MD
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  3. Dario Ribero MD
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  4. Alfredo Mellano MD
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  5. Luca Viganò MD
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  6. Lorenzo Capussotti MD
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Corresponding author

Correspondence to Andrea Muratore MD.

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Muratore, A., Zimmitti, G., Ribero, D. et al. Chemotherapy Between the First and Second Stages of a Two-Stage Hepatectomy for Colorectal Liver Metastases: Should We Routinely Recommend It?. Ann Surg Oncol 19, 1310–1315 (2012). https://doi.org/10.1245/s10434-011-2069-5

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  • DOI: https://doi.org/10.1245/s10434-011-2069-5

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