In their series, 34 of 43 patients (79.1%) with L-OHP developed SOS. Up to now, several investigators have reported the correlation between SOS and preoperative administration of L-OHP (Table 2).[27-37] These studies showed that 8.3–51.6%

MK0683 chemical structure of patients who received the administration of L-OHP with 5-FU-based chemotherapy developed grade 2–3 SOS. Regarding the correlation between the number of cycles of L-OHP treatment and the onset of SOS, Kishi et al. showed that sinusoidal injury was recognized in 46 of 79 patients (46%) and 22 of 38 patients (58%) after short (1–8 cycles) and long (≥9 cycles) duration preoperative FOLFOX, respectively.[37] In most studies, there was no correlation between the cumulative dose of L-OHP and the presence or severity of SOS. Nakano et al. only asserted that at least six cycles of L-OHP administration Antiinfection Compound Library significantly correlated with the onset of SOS.[31] Meanwhile, the defined discontinuous duration of treatment with L-OHP for regression of SOS has remained unclear. Though reports regarding this problem are few, Nakano et al. also reported that the interval between the cessation of L-OHP-based chemotherapy and hepatic resection was significantly longer in patients without SOS (6.5 ± 1.2 months) than in those with SOS (3.6 ± 0.8 months).[32] In contrast,

the persistence or progression of SOS 32 months after the cessation of L-OHP administration has been reported.[27] Though continuous duration of SOS induced by L-OHP is not still proven, most investigators have adopted 1–3 months as the time interval between cessation of chemotherapy and hepatic resection.[29, 30, 34, 37] Schiffer et al. demonstrated that the presence of SOS the induced impairment of liver regeneration, obstruction of hepatic microcirculation, increased portal pressure and decreased

bile flow associated with a decreased bile excretion of 153gadobenate dimeglumine, after partial hepatectomy in this rat model triclocarban of monoclotarine-induced SOS, suggesting that L-OHP may augment hepatic regeneration following major hepatic resection with increased perioperative complications.[38] There is only one clinical report regarding liver regeneration in patients who underwent portal vein embolization after L-OHP-based chemotherapy. SOS inhibited the future remnant liver hypertrophy after portal vein embolization and induced postoperative liver failure.[39] In clinical settings of patients with hepatic resection, some investigators evaluate the implication of perioperative complication in patients with L-OHP treatment (Table 2). Though there were more than a few reports indicating that morbidity risks did not increase after surgery, they were not investigating SOS cases in particular, but in all patients including those without SOS after preoperative chemotherapy. Aloia et al.