Liver regeneration impact on post-hepatectomy metastatic tumour recurrence

OBJECTIVE: To describes the responsible molecular pathways and the clinical importance of post-hepatectomy liver regeneration and investigates how the regenerative process promote metastatic tumour recurrence.METHODS: A total of 365 English papers were searched with liver regeneration,liver metastases,hepatectomy and tumor recurrence as search terms in Medline and PubMed databases from Jan,2007 to Mar,2012.Fifty papers were selected according to the standards as follows: 1)post-hepatectomy liver regeneration;2) the recurrence of liver metastasis;3) the relationship between post-hepatectomy live regeneration and the recurrence of liver metastasis.RESULTS: The regenerative process that occurs postoperatively is a complex phenomenon.Some molecules such as hepatocyte growth factor,tumour growth factor beta and matrix metalloproteinases promote tumour growth and may contribute to the recurrence of liver metastasis.The reactivation of dormant micrometastases or the intrahepatic accumulation of circulating malignant cells have been suggested as the responsible mechanism,although not clearly described.CONCLUSIONS: Post-hepatectomy liver regeneration can promote the recurrence of liver metastasis.Despite the considerable progress of the last decade,multiple queries remain to be clarified concerning liver regeneration.