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Chemotherapy-associated liver injury of patients undergoing therapy for colorectal liver metastases stimulates concerns on surgical safety. No common guidelines for the optimal timing of liver surgery after the application of systemic chemotherapy (chemotherapy-free interval) have been established and effects on individual liver function remain unexplored. Maximum liver function capacity (LiMAx) and indocyanine green plasma disappearance rate (ICG-PDR) were measured in 20 patients with colorectal cancer receiving adjuvant oxaliplatin-based chemotherapy (OBC) prior to the first and after the last treatment course as well as 4 and 8 weeks thereafter. Comparison of pre- and post-chemotherapy test results demonstrated a significant decrease of LiMAx to 73.2 % ± 19.0 % (p = 0.001) and ICG-PDR to 78.2 % ± 21.3 % (p = 0.001) after cessation of OBC. The dynamics of LiMAx indicate an interindividual effect on vulnerability to systemic chemotherapy with subsequent functional regeneration after 8 weeks (pre-OBC 530 ± 144 μg/kg/h vs. 4 weeks post-OBC 463 ± 111 μg/kg/; p = 0.012 and vs. 8 weeks post-OBC 494 ± 138 μg/kg/h; p = 0.134). An analysis of individual regeneration after chemotherapy yielded a highly different course of functional recovery with patients regaining pre-chemotherapy function within 4 weeks, whereas others still showed deterioration after 8 weeks after cessation of chemotherapy. Enzymatic liver function (LiMAx) is significantly reduced after oxaliplatin-based chemotherapy and subsequently recovers within 8 weeks after cessation of chemotherapy. However, pace of regeneration appears to be highly different among patients suggesting patient individual chemotherapy-free interval monitored by LiMAx.

Portal vein embolization (PVE) before extended right hepatectomy leads to an increase of the future liver remnant (FLR) volume, but predictive factors for sufficient hypertrophy are still unclear. The purpose of this study was to investigate parameters influencing the growth of FLR.Patients undergoing PVE prior hepatic resection were evaluated. PVE was done using polyvinyl alcohol particles only. Volumetric analysis was performed before embolization and before hepatectomy. Success of PVE was determined as percental growth of the future liver remnant.Seventy-seven patients were included, and three cohorts were formed according to the hypertrophy of FLR. FLR increased from 448.2 ± 187 to 475.5 ± 191 in the poor, from 315.3 ± 86 to 469.1 ± 142 in the moderate, and from 283.4 ± 68 to 400.4 ± 110 in the good hypertrophy group. More cases of recanalization of the portal vein were observed in patients with poor hypertrophy (p = 0.016). Small FLR before PVE predict higher growth of the FLR (p = 0.006). Duration between PVE and surgery differed significantly: 22 (poor) vs. 32 (good) days (p = 0.040).No recanalization, small initial FLR and longer time were assessed with better FLR hypertrophy. More sufficient PVE techniques and postponed hepatectomy might improve the outcome. Small initial FLR should not be a disclosure for curative hepatectomy.