Preoperative Chemotherapy Can Change the Surgical Procedure for Hepatectomy in XXXX with Liver Metastasis of @entity14 .

@entity5 @entity1 @entity14
AIM: The benefit of preoperative chemotherapy is evaluated in order to clarify the relationship of @entity5 site with hepatic vessels for hepatectomy. @entity5 location in relation to intrahepatic vessels is critical in the decision to operate, but the argument for this concept remains insufficient. Currently, the response rate is evaluated by the decrease in size or number of @entity5 but not by hepatic resection range. @entity1 AND METHODS: We evaluated 32 @entity1 who underwent hepatectomy after chemotherapy for liver metastases from @entity14 (CLM). @entity5 diameter was defined by contrast computed tomographic imaging before both chemotherapy and surgery. The targeted vessels were those in the main Glisson capsule and hepatic vein and were indicated to change in the resected area by their treatment. RESULTS: @entity5 size decreased, increased or remained unchanged in 62 (68.9%), 27 (30.0%) and one (1.1%) @entity5 , respectively. Out of the 29 @entity5 , reduced resection volume was achieved in 12 (37.9%), and the difference in volume was 17.4  4.15 ml. A significant positive correlation was found between @entity5 shrinkage rate and final distance from the attached vessels (p=0.017), and a shrinkage rate of 63.6  12.4% was necessary for a @entity5 to be separated from an attached vessel. The final distance was significantly positively correlated with @entity5 shrinkage speed (p=0.0027), and a shrinkage speed of 0.64  0.12%/day was expected to enable a a @entity5 to be separated from its attached vessel. CONCLUSION: Chemotherapy, especially by favorable combination with molecular targeting agents, even for resectable CLM appears to be acceptable and may lead to increased performance of radical surgical resection.
