Efficacy of conversion therapy on future liver remnant hypertrophy for initially unresectable colorectal liver metastases: a review of current status and perspectives / 中华肝胆外科杂志

ABSTRACT

Surgical resection is the only effectively curative option for patients with colorectal liver metastases (CRLM).However,fewer than 20％ of those patients are deemed eligible for surgery when they were initially diagnosed.Conversion therapy,mainly used by chemotherapy,increases the opportunities of surgical treatment for patients with initially unresectable CRLM.Notably,sufficient future liver remnant (FLR)is a key factor for liver resection.The deficiency of FLR could lead to serious complications including postoperative liver failure.Surgical methods,represented by portal vein embolization (PVE),portal vein ligation (PVL) and associating liver partition and portal vein ligation for staged hepatectomy (ALPPS),could increase FLR and subsequently further increase the surgical security for CRLM patients.Most CRLM patients accept systemic chemotherapy before surgery.With extensive research has revealed the chemotherapy-induced liver injury,more attention has been shifted to explore the influence of different chemotherapy regimens,chemotherapy cycles and timing of surgery on the volume of FLR.With this review,we overview the research status of conversion therapy for initial unresectable CELM and the influence of chemotherapy on the volume of FLR.