Neoadjuvant systemic chemotherapy is being increasingly used prior to liver resection for colorectal metastases.
Oxaliplatin has been implicated in causing structural changes to the liver parenchyma.
Such changes may increase the morbidity and mortality of surgery.
Dr Hewes and colleagues from England conducted a retrospective study of 101 patients who underwent liver resection for colorectal metastases in 2 centers.
The research team gathered Preoperative demographic and premorbid data along with liver function tests and tumor markers.
A subjective assessment of the surgical procedure was noted, and in-hospital morbidity and mortality were calculated.
|Overall morbidity was 37%|
|World Journal of Surgery|
The researchers analyzed the effect of preoperative chemotherapy on short-term and long-term outcome.
The team determined 1 and 3 year survival.
Patients who received neoadjuvant chemotherapy had a higher number of metastases, and more had synchronous tumors.
The researchers found that overall morbidity was 37%, and hospital mortality was 4%.
The research team observed that operative and in-hospital outcome was not influenced by chemotherapy.
The researchers noted that long-term survival was worse in patients who had received preoperative chemotherapy.
Dr Hewes' team concludes, “This study shows no evidence that neoadjuvant chemotherapy, and in particular oxaliplatin, increases the risk associated with liver resection for colorectal metastases.”
“Long-term outcome is reduced in patients receiving preoperative chemotherapy, although they have more advanced disease.”