Authors: Hannes P Neeff Oliver Drognitz Andrea Klock Gerald Illerhaus Oliver G Opitz Ulrich T Hopt Frank Makowiec
Publish Date: 2011/12/06
Volume: 27, Issue: 5, Pages: 635-645
Abstract
The impact of chemotherapy CTx on morbidity after liver resection for colorectal metastases CRCLM has been increasingly investigated during recent years Biologic agents like bevacizumab BEV or cetuximab CET are now added as “targeted therapy” TT also in neoadjuvant settings Initial series could demonstrate the safety of those regimens in liver resection but data are still scarce We evaluated the impact of CTx with BEV or CET CTx + TT on perioperative morbidity and mortalityTwo hundred thirtyseven patients who underwent liver resections for CRCLM after chemotherapy before surgery since 1999 were included One hundred eightyfive patients 78 had preoperative CTx regimen without biologic agents fluoropyrimidine oxaliplatin or irinotecanbased and 52 22 had CTx + TT 39 BEV 11 CET 2 CET/BEV After preoperative CTx + TT a time interval of at least 4–6 weeks and a residual liver volume of 35 before surgery were requiredHemihepatectomy or more was performed in about half of the patients The median amount of intraoperatively transfused blood was 0 ml in both groups p = 034 Overall mortality was 17 and slightly elevated in patients with CTx + TT 38 vs 11 p = 017 Any complication occurred in CTx + TT vs CTx 52 and 46 respectively p = 047 The rates of liver failure 96 vs 97 p = 098 infectious complications such as wound infection 19 vs 16 p = 062 and abdominal abscess 8 vs 65 p = 071 as well as the rate of relaparotomies 115 vs 70 p = 029 showed no significant differences between the groups with TT or without In multivariate analyses neither type nor duration of CTx nor the time interval between CTx and surgery showed any influence on complication rates
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