Sinusoidal Obstruction Syndrome Impairs Long-Term Outcome of Colorectal Liver Metastases Treated with Resection after Neoadjuvant Chemotherapy View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2010-09-16

AUTHORS

Dietmar Tamandl, Markus Klinger, Sandra Eipeldauer, Beata Herberger, Klaus Kaczirek, Birgit Gruenberger, Thomas Gruenberger

ABSTRACT

BackgroundChemotherapy-induced liver injury is a considerable problem in patients undergoing surgery for colorectal liver metastases, since an increase in postoperative morbidity and mortality has been observed. We investigated whether liver damage had further implications on long-term outcome in these patients.Materials and MethodsLiver specimens from 196 patients resected for colorectal liver metastases were evaluated for chemotherapy-associated hepatic damage in the nontumorous liver. Injury patterns were correlated with recurrence free (RFS) and overall survival (OS). Factors leading to sinusoidal injury were identified.ResultsPatients who developed grade 2 or 3 sinusoidal dilatation had a significantly shorter RFS (hazard ratio [HR] 2.05; 95% confidence interval [95% CI] 1.23–3.39, P = .005) and OS (HR 2.90; 95% CI 1.61–6.19, P < .001), compared to patients without this alteration. Those patients also had significantly more intrahepatic recurrences (66.7% vs 30.5%, P = .003). Other patterns of chemotherapy-associated liver damage (nonalcoholic steatohepatitis, fibrosis) were not associated with impaired survival. Factors indicating sinusoidal injury were oxaliplatin-based chemotherapy, tumor size >5 cm, and elevated alkaline phosphatase or gamma glutamyltransferase.ConclusionsSinusoidal obstruction syndrome due to oxaliplatin-based chemotherapy may not only compromise perioperative outcome, but can lead to early recurrence and decreased survival in the long term. Strategies to prevent this condition are clearly needed. More... »

PAGES

421-430

Identifiers

URI

http://scigraph.springernature.com/pub.10.1245/s10434-010-1317-4

DOI

http://dx.doi.org/10.1245/s10434-010-1317-4

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1042942016

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/20844968


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