Effects of preoperative chemotherapy on liver function tests after hepatectomy

Background/Aims: Surgical resection of liver metastases is performed increa singly frequently after chemotherapy, which can induce fatty degeneration, possibly modifying the postoperative course after hepatectomy. This study e valuated the effect of chemotherapy on postoperative liver function tests a ccording to the use of preoperative chemotherapy or not. Methodology: Thirty-two patients were operated on for isolated breast cance r hepatic metastases, after stabilization or complete response to systemic therapy. The first group included 20 patients operated on after chemotherap y (9 major and 11 minor hepatic resections). The second group included 12 p atients operated on without chemotherapy (3 major and 9 minor hepatic resec tions). Results: Histological examination after chemotherapy confirmed micronodular fatty degeneration in 85% of cases, versus none in the control group (P = 0.05). Fall in prothrombin time on day 1 (D1) was more marked in the chemot herapy group (58%) versus control group (74%) (P = 0.001). gamma -glutamyl transpeptidase did not rise on D7 in the chemotherapy group (1.4 x N), even after major hepatectomy (1.6 x N), in contrast with the control group, in which the mean gamma -glutamyl transpeptidase on D7 was 4.6 x N after major hepatectomy and 2 x N after minor hepatectomy (P = 0.05). Conclusions: Chemotherapy induces almost constant fatty degeneration of the liver. Hepatic regeneration in the postchemotherapy liver is delayed, as r eflected by a later and lower elevation of gamma -glutamyl transpeptidase. The predictive risk of liver failure, reflected by prothrombin time, follow ing minor hepatectomy on postchemotherapy Ever is similar to that of major hepatectomy to healthy liver.