Recovery time after liver resection

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Rock_Robster
Posts: 47
Joined: Thu Oct 25, 2018 5:27 am
Location: Melbourne, Australia

Recovery time after liver resection

Postby Rock_Robster » Mon Mar 11, 2019 7:56 pm

Hi all, I had my liver resection last week (open surgery, 3 segments, about 25% in total), and I feel very lucky that I could and that it all went really well. My next step is long course chemoradiation on my primary tumour, but I understand I need to heal first.

So for those of you that have had liver surgery, how long until you could recommence therapy?

My Google-fu is failing me here and I can’t see much research around this. I’m keen to get back on the horse ASAP, but also don’t want to jeopardise healing.

Thanks!
Male 36 years; Melbourne, Australia
10/2018 Dx: 3.5 cm rectal adenocarcinoma, 10 cm from verge. Well/mod diff (G1-2), T3bN1bM1a.
3 enlarged local lymph nodes and 4 liver lesions.
Mutation in NRAS (G13R; exon 2, codon 13). MSS; MMR proficient.
11/18 - 6 rounds neoadjuvant FOLFOX
12/18 - DVT, started clexane
3/19 - Liver resection, clear margins

AmyG
Posts: 60
Joined: Tue Dec 25, 2018 8:08 pm

Re: Recovery time after liver resection

Postby AmyG » Mon Mar 11, 2019 8:13 pm

How is your recovery going thus far?

I'm supposed to be having an open resection as well after 6 cycles and have no idea what to expect other than a 5-7 day hospital stay. I've only had the one surgery ever to remove my primary tumor but that was laparoscopic.

Care to share all the details?
42 dx @ 9wks pregnant w/baby #8 8/18
Originally thought to be stage 2, no lymphnodes involved 9/18
Spot on liver found prior to bowel resection 9/18
Liver biopsy, it's malignant 12/18
Stage IV, 1 liver met 4.7cm
2019 plan is to deliver baby early and start FOLFOX w/Avastin

Rock_Robster
Posts: 47
Joined: Thu Oct 25, 2018 5:27 am
Location: Melbourne, Australia

Re: Recovery time after liver resection

Postby Rock_Robster » Mon Mar 11, 2019 8:31 pm

Hi Amy, so far it’s been much better than I expected. I went in last Wednesday and walked out yesterday, day 5. I had a fair bit of pain on waking up, but they hit that hard and has been manageable ever since. I did have some minor lung deflation and fluid build-up on the right side, which apparently happens during longer surgeries (esp after chemo), but breathing and coughing exercises have stayed on top of that. It’s really important to take enough painkillers so you can breathe properly and do your rehab exercises, otherwise you can end up with other un-fun complications. My hospital had a good ERAS program, and I also borrowed some tips from MSK’s website.

I was quite interested in the research around avoiding surgery-induced metastasis, so I’ve been doing what I can to prioritise painkillers which aren’t immunosuppressive, and a few other things. That has meant some interesting discussions with anaesthetists, but we got there!

The wound is large but quite tidy; I’ve got a check with GP tomorrow then with surgeon in 2 weeks. Appetite-wise I’ve had to adjust to smaller, frequent meals, with lots of protein to support liver regeneration and avoid losing much muscle mass. Now I’m just focusing on eating, resting and keeping moving to try to keep any issues at bay and get back to treatment!

Let me know if anything else specific I can tell you about.
Male 36 years; Melbourne, Australia
10/2018 Dx: 3.5 cm rectal adenocarcinoma, 10 cm from verge. Well/mod diff (G1-2), T3bN1bM1a.
3 enlarged local lymph nodes and 4 liver lesions.
Mutation in NRAS (G13R; exon 2, codon 13). MSS; MMR proficient.
11/18 - 6 rounds neoadjuvant FOLFOX
12/18 - DVT, started clexane
3/19 - Liver resection, clear margins

martd
Posts: 68
Joined: Tue Nov 21, 2017 3:48 pm
Location: Phoenix, Az

Re: Recovery time after liver resection

Postby martd » Mon Mar 11, 2019 9:50 pm

I resumed folfox about two and a half weeks after my first resection. That surgery was laparoscopic. Removed 3 Mets then 3 days later PVE surgery.
49 y/o male dx 11/2017 crc
Stage 4 with 17 liver Mets, cea 490
RAS, BRAF WT
12 rounds folfox , avastin
5/18 cea 2.8 liver resection and pve
7/18 part 2 liver resection, remove right side of liver
Surgical site mrsa infection, wound vac
8/18 cea .9 cCR, rectal tumor is gone
Rectal surgery postponed, watch and wait
10/18 clear scan CEA .7
01/19 clear scan CEA .9

Rock_Robster
Posts: 47
Joined: Thu Oct 25, 2018 5:27 am
Location: Melbourne, Australia

Re: Recovery time after liver resection

Postby Rock_Robster » Mon Mar 11, 2019 10:08 pm

Thanks martd - that sounds fast! I think someone mentioned a 4-6 week recovery but perhaps I can restart treatment somewhere during that window as well.
Male 36 years; Melbourne, Australia
10/2018 Dx: 3.5 cm rectal adenocarcinoma, 10 cm from verge. Well/mod diff (G1-2), T3bN1bM1a.
3 enlarged local lymph nodes and 4 liver lesions.
Mutation in NRAS (G13R; exon 2, codon 13). MSS; MMR proficient.
11/18 - 6 rounds neoadjuvant FOLFOX
12/18 - DVT, started clexane
3/19 - Liver resection, clear margins

Milk Tea
Posts: 16
Joined: Wed Feb 13, 2019 1:14 pm

Re: Recovery time after liver resection

Postby Milk Tea » Mon Mar 11, 2019 10:47 pm

A few weeks after the surgery, my husband’s big L shape incision opened up in two places and I had to pack in fresh gauze in those two open wounds twice daily to help healing. Both open wounds closed up nicely after a few weeks. Because of that, it was almost 10 weeks after his open liver surgery, he started first mop up chemo. It was originally scheduled for 6 weeks after surgery.
Wife to DH
09/2016: Dx at 50, CC Ascending colon, 10+ liver Mets
KRAS-Mut G12V, MSS, CEA 8
09/2016: Nearly blocked, Emergency colon surgery (LAR)
FOLFOXIRI+Avastin: 6 before and 6 after liver resection
01/2017: Liver resection, open, both lobes, 40% total liver cut, tumors either cut out or microwave ablation burn, all tumors are out
02/2017-01/2019 : Clean CT every 3-4 months, CEA between 2-3
06/2017-Present: Maintenance Chemo: Xeloda + Avastin

Rock_Robster
Posts: 47
Joined: Thu Oct 25, 2018 5:27 am
Location: Melbourne, Australia

Re: Recovery time after liver resection

Postby Rock_Robster » Mon Mar 11, 2019 10:50 pm

Thanks Milk Tea, that’s very helpful. Glad it all worked out ok with the wound.
Male 36 years; Melbourne, Australia
10/2018 Dx: 3.5 cm rectal adenocarcinoma, 10 cm from verge. Well/mod diff (G1-2), T3bN1bM1a.
3 enlarged local lymph nodes and 4 liver lesions.
Mutation in NRAS (G13R; exon 2, codon 13). MSS; MMR proficient.
11/18 - 6 rounds neoadjuvant FOLFOX
12/18 - DVT, started clexane
3/19 - Liver resection, clear margins

Pyro
Posts: 87
Joined: Mon Oct 12, 2015 7:40 pm
Location: Tucson, AZ

Re: Recovery time after liver resection

Postby Pyro » Tue Mar 12, 2019 7:17 am

I had multiple open liver surgeries, as I recall it was about 6 weeks after surgery I resumed chemo/rad. The open ones definitely take longer to heal. I was in the hospital for about u days each liver surgery, the surgeries were a breeze compared to my colon surgery, but that was done fully open as well.
Last edited by Pyro on Tue Mar 12, 2019 7:20 am, edited 1 time in total.
Aug 2015- Diag Stage 4 CC with mets to liver (38/m)
Sep 2015- Avastin/Folfox/Iron
Dec 2015-Not a surgery candidate for liver
Jan 2016- Erbitux/Folfiri, 2nd opinion at MDA in TX
Feb 2016 -MDA liver surgery, Dr. Vauthey
Mar 2016 -30% of left lobe removed, PVE
May 2016 - 70% of liver removed
Jun 2016-Radiation
Jan 2017-permanent colost @MDA
Jul 2017-Erb/FOLFURI
Nov 2017 -Lung & Liver ablations@MDA
Jan 2018 -Xeloda & Avastin mx
Jul 2018-Avast/FOLFURI
Sep 2018-Radiation
Mar 2019 - Keytruda

Rock_Robster
Posts: 47
Joined: Thu Oct 25, 2018 5:27 am
Location: Melbourne, Australia

Re: Recovery time after liver resection

Postby Rock_Robster » Tue Mar 12, 2019 7:19 am

Thanks Pyro, makes sense
Male 36 years; Melbourne, Australia
10/2018 Dx: 3.5 cm rectal adenocarcinoma, 10 cm from verge. Well/mod diff (G1-2), T3bN1bM1a.
3 enlarged local lymph nodes and 4 liver lesions.
Mutation in NRAS (G13R; exon 2, codon 13). MSS; MMR proficient.
11/18 - 6 rounds neoadjuvant FOLFOX
12/18 - DVT, started clexane
3/19 - Liver resection, clear margins

Gravelyguy
Posts: 122
Joined: Thu Jul 05, 2018 6:03 pm

Re: Recovery time after liver resection

Postby Gravelyguy » Tue Mar 12, 2019 5:35 pm

I started mop up chemo 6 weeks after my Combo liver and rectal resection. I had done short course radiation just before surgery so not sure if they might wait longer to do post surgery radiation. Glad it went well and you are home!

Dave
6/17 dx mCRC t3n1m1 very low rectal tumor 2 liver Mets 1.3 cm and .9 cm

6/17 begin 4 rounds Folfox w/Vectibix
9/17 short course radiation
10/17 rectal and liver resection cancer is out of here!
11/17-3/18 8 rounds Folfox
6/18 still NED!! Takedown
8/28/18 still NED! CEA .8 new low for me
10/18/18 colonoscopy clear
12/12/18 clear scans, CEA .9 still NED!


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