Preoperative Chemotherapy with Gemcitabine and Cisplatin for Biliary Tract Cancer Does Not Affect Liver Regeneration Induced by Portal Vein Embolization.

BACKGROUND

Although perioperative chemotherapy has recently been advocated for patients with biliary tract cancer (BTC) undergoing resection, little is known about its risks and efficacy in those who also require preoperative portal vein embolization (PVE) to secure residual liver capacity. This study aimed to examine liver hypertrophy and perioperative outcomes in patients with BTC treated with preoperative chemotherapy and PVE.

METHODS

A total of 186 patients who underwent PVE for BTC in our institution were retrospectively analyzed. Patients were divided into two groups: those who received gemcitabine and cisplatin chemotherapy after PVE (P+C group, n=57) and those who did not (P group, n=129). Propensity score matching was performed to reduce bias. Liver hypertrophy, liver function, and perioperative outcomes were compared. We also examined the frequency of chemotherapy-related adverse events.

RESULTS

After matching, the degree of liver hypertrophy and the kinetic growth rates after PVE were similar between the two groups. Liver enzyme changes and indocyanine green test results also showed no significant differences. The resection rates were 88.4% in the P group and 61.4% in the P+C group. Postoperative complication rates among the resected cases were comparable between the groups. Moreover, no increase in chemotherapy-related adverse events was observed when chemotherapy was administered concurrently with PVE.

CONCLUSION

Perioperative gemcitabine and cisplatin chemotherapy in patients with BTC did not significantly suppress PVE-induced liver hypertrophy or impair liver function. It did not impact on postoperative complications or chemotherapy-related adverse events.