Abnormal Liver Function Induced by Space-Occupying Lesions Is Associated with Unfavorable Oncologic Outcome in Patients with Colorectal Cancer Liver Metastases

Abstract

An early prediction of prognosis for patients with colorectal liver metastasis (CRLM) may help us determine treatment strategies. Liver function reflects the effect of the overall metastatic burden. We investigated the prognostic value of liver function in CRLM patients. In our study, patients with abnormal LFTs (liver function tests) had a poorer prognosis than did those with normal LFTs (P < 0.05). A multivariate analysis revealed that LFTs was an independent prognostic factor for CRLM. For those patients with abnormal LFTs, novel prognostic contour maps were generated using LFTs, and no positive correlation exists between the values of survival duration and abnormal LFTs. Additionally, the MTVR (metastatic tumor volume ratio) was measured directly by magnetic resonance imaging and was shown to be highly correlated to LFTs by a Pearson correlation analysis. A multivariate logistic regression analysis also demonstrated that the MTVR and hepatectomy were independently predictive of abnormal LFTs. The space-occupying effect of metastatic lesions can cause abnormal LFTs, resulting in a poor prognosis. Biochemical analyses of LFTs at the initial diagnosis of CRLM enable the stratification of patients into low- and high-risk groups; it may help clinicians determine promising treatment strategies.

Predictive impact of the inflammation-based indices in uveal melanoma liver metastases treated with transarterial hepatic chemoperfusion

“…Aside from immune markers, elevated Liver enzymes (AST and ALT) >ULN were identified as prognostic factors in univariate analysis for overall survival with ALT proving as independent as also by others in metastatic liver disease. 31 It may be speculated that ALT and/or AST rise due to “space-occupying effects” associated with higher tumor burden, which could be confirmed in this patient set.…”

Proteomics of colorectal cancer liver metastasis: A quantitative focus on drug elimination and pharmacodynamics effects

“…The liver function markers alanine aminotransferase, alkaline phosphatase and aspartate aminotransferase are reported to be increased in the plasma in many cancer patients 37 . Figure 6A shows that in livers all 3 appeared to be decreased (up to 7.6‐fold).…”

Hepatic Scaling Factors for In Vitro–In Vivo Extrapolation of Metabolic Drug Clearance in Patients with Colorectal Cancer with Liver Metastasis

“…Our simulations show that using appropriate MPPGL values for a certain population is important for the prediction of drug exposure; however, the applied MPPGL value should be accompanied by the percentage of cancerous liver in each patient. Although the percentage of cancerous liver is not known for the present study, it is common practice for major hepatectomy to resect up to 70% of the total liver for a sufficient liver function, including histologically normal and cancerous tissue (Hemming et al, 2003;Jiang et al, 2018). As a result, there may be a significant contribution of the tumour to the overall liver activity in CRLM patients.…”

“…Metastasis to the liver constitutes one of the main causes of mortality in patients with colorectal cancer (Siegel et al, 2018) as it accounts for 70% of metastases from colorectal cancer, followed by metastasis to the lungs, distant lymph nodes, and peritoneum (Holch et al, 2017). Metastasis to the liver can affect hepatic function as the resultant lesions occupy space in liver tissue leading to abnormal liver function tests (Jiang et al, 2018).…”