A Reappraisal of Chemotherapy-Induced Liver Injury in Colorectal Liver Metastases before the Era of Antiangiogenics
Background and Aims. Chemotherapy of colorectal liver metastases can induce hepatotoxicity in noncancerous liver. We describe these lesions and assess risk factors and impacts on postresection morbidity and mortality in naive patients to chemotherapy before the era of bevacizumab. Methods. Noncancer...
Saved in:
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2013-01-01
|
| Series: | International Journal of Hepatology |
| Online Access: | http://dx.doi.org/10.1155/2013/314868 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850167231036522496 |
|---|---|
| author | Eric Nguyen-Khac Céline Lobry Denis Chatelain David Fuks Jean Paul Joly Marie Brevet Blaise Tramier Charlotte Mouly Vincent Hautefeuille Bruno Chauffert Jean Marc Regimbeau |
| author_facet | Eric Nguyen-Khac Céline Lobry Denis Chatelain David Fuks Jean Paul Joly Marie Brevet Blaise Tramier Charlotte Mouly Vincent Hautefeuille Bruno Chauffert Jean Marc Regimbeau |
| author_sort | Eric Nguyen-Khac |
| collection | DOAJ |
| description | Background and Aims. Chemotherapy of colorectal liver metastases can induce hepatotoxicity in noncancerous liver. We describe these lesions and assess risk factors and impacts on postresection morbidity and mortality in naive patients to chemotherapy before the era of bevacizumab. Methods. Noncancerous liver tissue lesions were analysed according to tumour, chemotherapy, surgery, and patient characteristics.
Results. Fifty patients aged 62 ± 9.3 years were included between 2003 and 2007. Thirty-three (66%) received chemotherapy, with Folfox (58%), Folfiri (21%), LV5FU2 (12%), or Xelox (9%) regimens. Hepatotoxicity consisted of 18 (36%) cases of severe sinusoidal dilatation (SD), 13 (26%) portal fibrosis, 7 (14%) perisinusoidal fibrosis (PSF), 6 (12%) nodular regenerative hyperplasia (NRH), 2 (4%) steatosis >30%, zero steatohepatitis, and 16 (32%) surgical hepatitis. PSF was more frequent after chemotherapy (21% versus 0%, ), especially LV5FU2 (). SD was associated with oxaliplatin (54.5% versus 23.5%, ) and low body mass index (). NRH was associated with oxaliplatin () and extensive resection (). No impact on mortality and morbidity was observed, apart postoperative elevation of bilirubin levels in case of PSF (), longer hospitalization in case of surgical hepatitis (), and greater blood loss in case of portal fibrosis ().
Conclusions. Chemotherapy of colorectal liver metastases induces sinusoidal dilatation related to oxaliplatin and perisinusoidal fibrosis related to 5FU, without any impact on postoperative mortality. |
| format | Article |
| id | doaj-art-e2b0ba0a7d9d4a1bb0be874e39fea5ef |
| institution | OA Journals |
| issn | 2090-3448 2090-3456 |
| language | English |
| publishDate | 2013-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | International Journal of Hepatology |
| spelling | doaj-art-e2b0ba0a7d9d4a1bb0be874e39fea5ef2025-08-20T02:21:14ZengWileyInternational Journal of Hepatology2090-34482090-34562013-01-01201310.1155/2013/314868314868A Reappraisal of Chemotherapy-Induced Liver Injury in Colorectal Liver Metastases before the Era of AntiangiogenicsEric Nguyen-Khac0Céline Lobry1Denis Chatelain2David Fuks3Jean Paul Joly4Marie Brevet5Blaise Tramier6Charlotte Mouly7Vincent Hautefeuille8Bruno Chauffert9Jean Marc Regimbeau10Department of Hepatology, Amiens University Hospital, Place Victor Pauchet, 80054 Amiens Cedex 01, FranceDepartment of Hepatology, Amiens University Hospital, Place Victor Pauchet, 80054 Amiens Cedex 01, FranceDepartment of Pathology, Amiens University Hospital, Place Victor Pauchet, 80054 Amiens Cedex 01, FranceDepartment of Digestive Surgery, Amiens University Hospital, Place Victor Pauchet, 80054 Amiens Cedex 01, FranceDepartment of Hepatology, Amiens University Hospital, Place Victor Pauchet, 80054 Amiens Cedex 01, FranceDepartment of Pathology, Amiens University Hospital, Place Victor Pauchet, 80054 Amiens Cedex 01, FranceBiostatistic Department, Amiens University Hospital, Place Victor Pauchet, 80054 Amiens Cedex 01, FranceDepartment of Digestive Surgery, Amiens University Hospital, Place Victor Pauchet, 80054 Amiens Cedex 01, FranceDepartment of Hepatology, Amiens University Hospital, Place Victor Pauchet, 80054 Amiens Cedex 01, FranceDepartment of Medical Oncology, Amiens University Hospital, Place Victor Pauchet, 80054 Amiens Cedex 01, FranceDepartment of Digestive Surgery, Amiens University Hospital, Place Victor Pauchet, 80054 Amiens Cedex 01, FranceBackground and Aims. Chemotherapy of colorectal liver metastases can induce hepatotoxicity in noncancerous liver. We describe these lesions and assess risk factors and impacts on postresection morbidity and mortality in naive patients to chemotherapy before the era of bevacizumab. Methods. Noncancerous liver tissue lesions were analysed according to tumour, chemotherapy, surgery, and patient characteristics. Results. Fifty patients aged 62 ± 9.3 years were included between 2003 and 2007. Thirty-three (66%) received chemotherapy, with Folfox (58%), Folfiri (21%), LV5FU2 (12%), or Xelox (9%) regimens. Hepatotoxicity consisted of 18 (36%) cases of severe sinusoidal dilatation (SD), 13 (26%) portal fibrosis, 7 (14%) perisinusoidal fibrosis (PSF), 6 (12%) nodular regenerative hyperplasia (NRH), 2 (4%) steatosis >30%, zero steatohepatitis, and 16 (32%) surgical hepatitis. PSF was more frequent after chemotherapy (21% versus 0%, ), especially LV5FU2 (). SD was associated with oxaliplatin (54.5% versus 23.5%, ) and low body mass index (). NRH was associated with oxaliplatin () and extensive resection (). No impact on mortality and morbidity was observed, apart postoperative elevation of bilirubin levels in case of PSF (), longer hospitalization in case of surgical hepatitis (), and greater blood loss in case of portal fibrosis (). Conclusions. Chemotherapy of colorectal liver metastases induces sinusoidal dilatation related to oxaliplatin and perisinusoidal fibrosis related to 5FU, without any impact on postoperative mortality.http://dx.doi.org/10.1155/2013/314868 |
| spellingShingle | Eric Nguyen-Khac Céline Lobry Denis Chatelain David Fuks Jean Paul Joly Marie Brevet Blaise Tramier Charlotte Mouly Vincent Hautefeuille Bruno Chauffert Jean Marc Regimbeau A Reappraisal of Chemotherapy-Induced Liver Injury in Colorectal Liver Metastases before the Era of Antiangiogenics International Journal of Hepatology |
| title | A Reappraisal of Chemotherapy-Induced Liver Injury in Colorectal Liver Metastases before the Era of Antiangiogenics |
| title_full | A Reappraisal of Chemotherapy-Induced Liver Injury in Colorectal Liver Metastases before the Era of Antiangiogenics |
| title_fullStr | A Reappraisal of Chemotherapy-Induced Liver Injury in Colorectal Liver Metastases before the Era of Antiangiogenics |
| title_full_unstemmed | A Reappraisal of Chemotherapy-Induced Liver Injury in Colorectal Liver Metastases before the Era of Antiangiogenics |
| title_short | A Reappraisal of Chemotherapy-Induced Liver Injury in Colorectal Liver Metastases before the Era of Antiangiogenics |
| title_sort | reappraisal of chemotherapy induced liver injury in colorectal liver metastases before the era of antiangiogenics |
| url | http://dx.doi.org/10.1155/2013/314868 |
| work_keys_str_mv | AT ericnguyenkhac areappraisalofchemotherapyinducedliverinjuryincolorectallivermetastasesbeforetheeraofantiangiogenics AT celinelobry areappraisalofchemotherapyinducedliverinjuryincolorectallivermetastasesbeforetheeraofantiangiogenics AT denischatelain areappraisalofchemotherapyinducedliverinjuryincolorectallivermetastasesbeforetheeraofantiangiogenics AT davidfuks areappraisalofchemotherapyinducedliverinjuryincolorectallivermetastasesbeforetheeraofantiangiogenics AT jeanpauljoly areappraisalofchemotherapyinducedliverinjuryincolorectallivermetastasesbeforetheeraofantiangiogenics AT mariebrevet areappraisalofchemotherapyinducedliverinjuryincolorectallivermetastasesbeforetheeraofantiangiogenics AT blaisetramier areappraisalofchemotherapyinducedliverinjuryincolorectallivermetastasesbeforetheeraofantiangiogenics AT charlottemouly areappraisalofchemotherapyinducedliverinjuryincolorectallivermetastasesbeforetheeraofantiangiogenics AT vincenthautefeuille areappraisalofchemotherapyinducedliverinjuryincolorectallivermetastasesbeforetheeraofantiangiogenics AT brunochauffert areappraisalofchemotherapyinducedliverinjuryincolorectallivermetastasesbeforetheeraofantiangiogenics AT jeanmarcregimbeau areappraisalofchemotherapyinducedliverinjuryincolorectallivermetastasesbeforetheeraofantiangiogenics AT ericnguyenkhac reappraisalofchemotherapyinducedliverinjuryincolorectallivermetastasesbeforetheeraofantiangiogenics AT celinelobry reappraisalofchemotherapyinducedliverinjuryincolorectallivermetastasesbeforetheeraofantiangiogenics AT denischatelain reappraisalofchemotherapyinducedliverinjuryincolorectallivermetastasesbeforetheeraofantiangiogenics AT davidfuks reappraisalofchemotherapyinducedliverinjuryincolorectallivermetastasesbeforetheeraofantiangiogenics AT jeanpauljoly reappraisalofchemotherapyinducedliverinjuryincolorectallivermetastasesbeforetheeraofantiangiogenics AT mariebrevet reappraisalofchemotherapyinducedliverinjuryincolorectallivermetastasesbeforetheeraofantiangiogenics AT blaisetramier reappraisalofchemotherapyinducedliverinjuryincolorectallivermetastasesbeforetheeraofantiangiogenics AT charlottemouly reappraisalofchemotherapyinducedliverinjuryincolorectallivermetastasesbeforetheeraofantiangiogenics AT vincenthautefeuille reappraisalofchemotherapyinducedliverinjuryincolorectallivermetastasesbeforetheeraofantiangiogenics AT brunochauffert reappraisalofchemotherapyinducedliverinjuryincolorectallivermetastasesbeforetheeraofantiangiogenics AT jeanmarcregimbeau reappraisalofchemotherapyinducedliverinjuryincolorectallivermetastasesbeforetheeraofantiangiogenics |