Abstract: Objective
To investigate the effects of neoadjuvant chemotherapy on the hepatic function and histology of liver in patients with hepatic metastasis of colorectal cancer.
Methods
The clinical data of 65 patients with hepatic metastasis of colorectal cancer who received hepatectomy at the First People′s Hospital of Foshan from January 2010 to September 2012 were retrospectively analyzed. Thirty nine patients were in the experimental group, and they received partial hepatectomy 1 month after receiving a 6 month continous FOLFOX7 chemotherapy (5 fluorouracil+calcium leucovorin+oxaloplatin); 39 patients were in the control group, and they received partial hepatectomy without adjuvant chemotherapy. The perioperative condition, pre and postoperative hepatic function, postoperative complications and the histopathological changes of the hepatic tissues of the 2 groups were compared by t test or chi square test, data repeated measured were analyzed using the repeated measure analysis of variance.
Results
(348±44)ml of the control group (t=6.3,P<0.05).The levels of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) at postoperative day 3 were (328±121)U/L and (330±120)U/L in the experimental group, which were significantly higher than (160±22) U/L and (168±26) U/L of the control group (t=13.4, 12.8, P<0.05). There were no significant differences in the levels of prothrombin time, AST, ALT, total bilirubin and albumin between the experimental group and the control group (t=1.0, 0.0, 1.4, 1.3, 0.4, P>0.05). The levels of AST and ALT at postoperative day 7 were (243±132)U/L and (253±147)U/L in the experimental group, which were significantly higher than (90±17)U/L and (99±16)U/L of the control group (t=12.5, 12.0, P<0.05). The incidence of congestion and edema of the liver was 71.8%(28/39) in the experimental group, which was significantly higher than 0 (0/26) of the control group (χ2=90.0, P<0.05). The incidence of hepatic sinusoid expansion with liver cellular altrophy and necrosis was 48.7%(19/39), which was significantly higher than 15.4%(4/26) of the control group (χ2=89.2, P<0.05).Conclusion
There is no effect of long time FOLFOX7 chemotherapy on the hepatic function of the patients with hepatic metastasis of colorectal cancer who received hepatectomy 1 month later, but the postoperative hepatic function is affected. The hepatic parenchyma is changed after adjuvant chemotherapy, which might have adverse effect on hepatectomy.