Journal article
Impact of biological agents on the prevalence of chemotherapy associated liver injury (CALI): Multicentric study of patients operated for colorectal liver metastases.
- Hubert C Division of Hepato-Biliary and Pancreatic Surgery, Department of Abdominal Surgery and Transplantation, Saint-Luc University Hospital, Université Catholique de Louvain (UCL), Hippocrate Avenue, 10 1200 Brussels, Belgium. Electronic address: Catherine.hubert@uclouvain.be.
- Lucidi V Department of Digestive Surgery, Erasme Hospital, Université Libre de Bruxelles, 1070 Brussels, Belgium.
- Weerts J Department of Digestive Surgery, Clinique St Joseph, 4000 Liège, Belgium.
- Dili A Department of Digestive Surgery, Hopital de Jolimont, 7100 Jolimont, Belgium.
- Demetter P Department of Pathology, Erasme Hospital, Université Libre de Bruxelles, 1070 Brussels, Belgium.
- Massart B Department of Pathology, Clinique St Joseph, 4000 Liège, Belgium.
- Komuta M Department of Pathology, Saint-Luc University Hospital Université Catholique de Louvain (UCL), 1200 Brussels, Belgium.
- Navez J Division of Hepato-Biliary and Pancreatic Surgery, Department of Abdominal Surgery and Transplantation, Saint-Luc University Hospital, Université Catholique de Louvain (UCL), Hippocrate Avenue, 10 1200 Brussels, Belgium.
- Reding R Division of Hepato-Biliary and Pancreatic Surgery, Department of Abdominal Surgery and Transplantation, Saint-Luc University Hospital, Université Catholique de Louvain (UCL), Hippocrate Avenue, 10 1200 Brussels, Belgium.
- Gigot JF Division of Hepato-Biliary and Pancreatic Surgery, Department of Abdominal Surgery and Transplantation, Saint-Luc University Hospital, Université Catholique de Louvain (UCL), Hippocrate Avenue, 10 1200 Brussels, Belgium.
- Sempoux C Department of Pathology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
- 2018-08-11
Published in:
- European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology. - 2018
Biological agents
CALI
Colorectal liver metastases
Adult
Aged
Aged, 80 and over
Antineoplastic Agents
Antineoplastic Combined Chemotherapy Protocols
Belgium
Bevacizumab
Biological Products
Chemical and Drug Induced Liver Injury
Colorectal Neoplasms
Female
Fluorouracil
Hepatic Veno-Occlusive Disease
Humans
Leucovorin
Liver Neoplasms
Male
Middle Aged
Organoplatinum Compounds
Postoperative Complications
Prevalence
English
BACKGROUND
The prevalence of chemotherapy associated liver injuries (CALI), especially SOS (sinusoidal obstruction syndrome) and NRH (nodular regenerative hyperplasia) might be reduced since the introduction of routine use of biological agents with chemotherapy in colorectal liver metastases (CRLM).
METHODS
One hundred patients with CRLM having undergone at least one liver segment resection were prospectively included, and chemotherapy data recorded. Specimens were reviewed by a single pathologist and CALI were described. Prevalence of CALI was compared to our previous experience published in 2013. NRH diagnosis was performed on reticulin special stain, by contrast to our previous study. Postoperative outcome was analysed.
RESULTS
Bevacizumab was more frequently administrated in patients of the present study: 53/100 (53%) compared to 20/151 (13%), p < 0.0001. Overall, in the present series, SOS was only observed in 28/100 (28%) patients compared to 116/151 (77%) in 2013 (p < 0.001). When looking specifically to patients receiving Bevacizumab with Folfox, we observed a reduced SOS prevalence compared to Folfox alone (p = 0.008). A higher prevalence of NRH was found in the present study, related to increased detection accuracy, but in patients receiving Bevacizumab in association with Folfox, this prevalence was also reduced compared to Folfox alone (p = 0.03). Both SOS and NRH were associated with severe complications (p = 0.008 and p = 0.005, respectively) and postoperative liver insufficiency (p < 0.001 and p < 0.01, respectively).
CONCLUSIONS
The routine use of Bevacizumab in association with Folfox significantly reduced CALI prevalence, in turn linked to severe postoperative complications.
The prevalence of chemotherapy associated liver injuries (CALI), especially SOS (sinusoidal obstruction syndrome) and NRH (nodular regenerative hyperplasia) might be reduced since the introduction of routine use of biological agents with chemotherapy in colorectal liver metastases (CRLM).
METHODS
One hundred patients with CRLM having undergone at least one liver segment resection were prospectively included, and chemotherapy data recorded. Specimens were reviewed by a single pathologist and CALI were described. Prevalence of CALI was compared to our previous experience published in 2013. NRH diagnosis was performed on reticulin special stain, by contrast to our previous study. Postoperative outcome was analysed.
RESULTS
Bevacizumab was more frequently administrated in patients of the present study: 53/100 (53%) compared to 20/151 (13%), p < 0.0001. Overall, in the present series, SOS was only observed in 28/100 (28%) patients compared to 116/151 (77%) in 2013 (p < 0.001). When looking specifically to patients receiving Bevacizumab with Folfox, we observed a reduced SOS prevalence compared to Folfox alone (p = 0.008). A higher prevalence of NRH was found in the present study, related to increased detection accuracy, but in patients receiving Bevacizumab in association with Folfox, this prevalence was also reduced compared to Folfox alone (p = 0.03). Both SOS and NRH were associated with severe complications (p = 0.008 and p = 0.005, respectively) and postoperative liver insufficiency (p < 0.001 and p < 0.01, respectively).
CONCLUSIONS
The routine use of Bevacizumab in association with Folfox significantly reduced CALI prevalence, in turn linked to severe postoperative complications.
- Language
-
- English
- Open access status
- closed
- Identifiers
-
- DOI 10.1016/j.ejso.2018.07.050
- PMID 30093084
- Persistent URL
- https://sonar.ch/global/documents/20503
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