What is a safe future liver remnant size in patients undergoing major hepatectomy for colorectal liver metastases and treated by intensive preoperative chemotherapy
Annals of Surgical Oncology,

Narita M et al. – This study provides a cutoff future liver remnant (FLR) ratio for safe postoperative outcome after major hepatectomy in colorectal liver metastases (CLM) patients receiving six or more cycles of preoperative chemotherapy.

Methods
  • Between January 2000 and August 2010, a total of 101 consecutive patients with CLM underwent major hepatectomy after preoperative chemotherapy (≥6 cycles of oxaliplatin or irinotecan regimen with or without targeted therapies).
  • The FLR ratio was calculated by two formulas: actual FLR (aFLR) ratio, and standardized FLR (sFLR) ratio.
  • Predictors of postoperative overall morbidity, sepsis, and liver failure were identified by univariate and multivariate analyses.

Results
  • Fifty–eight patients (57.4%) had 95 postoperative complications.
  • Sepsis and postoperative liver failure occurred in 23 (22.8%) and 16 patients (15.8%), respectively.
  • On univariate analysis, small aFLR ratio was significantly associated with all complications, and sFLR ratio was associated with sepsis and liver failure.
  • In receiver–operating characteristic analysis, the cutoff of aFLR ratio in predicting overall morbidity, sepsis, and liver failure was 44.8, 43.1, and 37.7%, respectively, and that of sFLR ratio in predicting sepsis and liver failure was 43.6 and 48.5%, respectively.
  • On multivariate analysis, these aFLR and sFLR ratio cutoffs were independent predictors of all complications and of sepsis and liver failure, respectively.

Please login or register to follow this author.
Are you sure you want to Unfollow this Author?
► Click here to access PubMed, Publisher and related articles...
<< Previous Article | Next Article >>

Your Unread Messages in Gastroenterology

See All >> Messages include industry-sponsored communications and special communications from MDLinx

Most Popular Gastroenterology Articles

1 Screening prior to biological therapy in Crohn's disease: Adherence to guidelines and prevalence of infections. Results from a multicentre retrospective study Digestive and Liver Diseases, August 4, 2014    Clinical Article

2 A prospective, randomized, controlled, exploratory study of comprehensive dietary advice in ulcerative colitis: impact on disease activity and quality of life European Journal of Gastroenterology & Hepatology, July 10, 2014    Clinical Article

3 Fecal lactoferrin in discriminating inflammatory bowel disease from irritable bowel syndrome: A diagnostic meta-analysis Full Text BMC Gastroenterology, July 14, 2014    Free full text    Evidence Based Medicine

4 Bolus administration of steroid therapy is more favorable than the conventional use in preventing decrease of bone density and the increase of body fat percentage in patients with inflammatory bowel disease Journal of Crohn's and Colitis, August 22, 2014    Clinical Article

5 The impact of preoperative steroid use on short-term outcomes following surgery for inflammatory bowel disease Journal of Crohn's and Colitis, August 8, 2014    Clinical Article

6 Prognostic effect of p53 expression in patients with completely resected colorectal cancer Tumor Biology, July 18, 2014    Clinical Article

7 Proton pump inhibitor use significantly increases the risk of spontaneous bacterial peritonitis in 1965 patients with cirrhosis and ascites: a propensity score matched cohort study Alimentary Pharmacology and Therapeutics, August 1, 2014    Clinical Article

8 Risk of drug-induced liver injury from tumor necrosis factor antagonists Clinical Gastroenterology and Hepatology , August 25, 2014    Clinical Article

9 Inflammatory bowel disease and cervical neoplasia: a population-based nationwide cohort study Clinical Gastroenterology and Hepatology , August 14, 2014    Clinical Article

10 Colesevelam for the treatment of bile acid malabsorption-associated diarrhea in patients with Crohn's disease: A randomized, double-blind, placebo-controlled study Journal of Crohn's and Colitis, August 27, 2014    Clinical Article

11 Risk of lymphoma in patients with inflammatory bowel disease treated with azathioprine and 6-mercaptopurine: a meta-analysis Clinical Gastroenterology and Hepatology , June 25, 2014    Evidence Based Medicine    Clinical Article

12 Magnetic resonance enterography, small-intestine contrast US, and capsule endoscopy to evaluate the small bowel in pediatric Crohn's disease: A prospective, blinded, comparison study Gastrointestinal Endoscopy, August 18, 2014    Clinical Article

13 The vitamin D status in inflammatory bowel disease PLOS ONE, July 18, 2014    Clinical Article
Exclusive Author Commentary

14 Moxibustion and acupuncture for the treatment of Crohn’s disease Full Text World Journal of Gastroenterology, August 29, 2014    Free full text    Clinical Article

15 Once versus three times daily dosing of oral budesonide for active Crohn's disease: A double-blind, double-dummy, randomised trial Journal of Crohn's and Colitis, August 28, 2014    Clinical Article

16 Comparing omeprazole with fluoxetine for treatment of patients with heartburn and normal endoscopy who failed once daily proton pump inhibitors: Double-blind placebo-controlled trial Neurogastroenterology & Motility, February 10, 2014    Clinical Article

17 An accelerated infliximab induction regimen reduces the need for early colectomy in patients with acute severe ulcerative colitis Clinical Gastroenterology and Hepatology , August 6, 2014    Clinical Article

18 Increased risk of venous thromboembolic events with corticosteroid vs biologic therapy for inflammatory bowel disease Clinical Gastroenterology and Hepatology , July 25, 2014    Clinical Article

19 Factors associated with pregnancy outcome in anti-TNF treated women with inflammatory bowel disease Alimentary Pharmacology and Therapeutics, July 3, 2014    Clinical Article

20 Subcutaneous ustekinumab for the treatment of anti-TNF resistant Crohn's disease-The McGill experience Journal of Crohn's and Colitis, July 9, 2014    Clinical Article

Indexed Journals in Gastroenterology: Gastroenterology, American Journal of Gastroenterology, Gutmore

Register now to view all the MDLinx contents (FREE)!

  • Stay current on the latest literature, research and clinical news
  • Get special communications and offers from MDLinx and our sponsors
  • Receive invitations to paid market research
View Samples and Register

Connect with us, stay current.

Receive the latest mecial news
updates for free via email

Sign up!

Subscribe to our free RSS feeds:

Get the latest news in your specialty automatically added to your newsreader or your personal My Yahoo!, Google, My MSN or My AOL page. Learn More

Close