Effect of preoperative chemotherapy on liver resection for colorectal liver metastases

Mehta, Naimish; Ravikumar, R; Coldham, C.; Buckels, J. A. C.; Hübscher, Stefan G.; Bramhall, Simon R.; Wigmore, Stephen J.; Mayer, A. D.; Mirza, Darius F.

doi:10.1016/j.ejso.2007.09.007

Cited by 90 publications

(55 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Particularly, incidence of SOS in patients treated with oxaliplatin showed higher incidence of SOS (51-79%) than that in patients treated with other drugs (21-30%) [1][2][3]. Histologically, it is characterised by obliteration of small hepatic venules with surrounding fibrosis and clogging of the sinusoids with debris from endothelial cell necrosis [4,5].…”

Section: Introductionmentioning

confidence: 99%

Accuracy of gadoxetic acid-enhanced magnetic resonance imaging for the diagnosis of sinusoidal obstruction syndrome in patients with chemotherapy-treated colorectal liver metastases

et al. 2011

View full text Add to dashboard Cite

show abstract

Section: Introductionmentioning

confidence: 99%

Accuracy of gadoxetic acid-enhanced magnetic resonance imaging for the diagnosis of sinusoidal obstruction syndrome in patients with chemotherapy-treated colorectal liver metastases

et al. 2011

View full text Add to dashboard Cite

show abstract

“…At least 6 studies have examined the clinical impact of sinusoidal injuries with respect to liver resection [20,23,24,25,26,27]. Findings of the studies are remarkably consistent.…”

Section: Problems Of Preoperative Chemotherapymentioning

confidence: 83%

“…Findings of the studies are remarkably consistent. No study to date has demonstrated increased mortality after hepatic resection in patients with oxaliplatin-related sinusoidal injury, and morbidity is at most minimally increased with short-course preoperative therapy [20,23,24,25]. In the prospective European Organisation for Research and Treatment of Cancer (EORTC) study using 6 cycles of 5-fluorouracil, leucovorin and oxaliplatin (FOLFOX), only 1 of 159 patients was found to be unresectable as a result of ‘liver injury’ [27].…”

Section: Problems Of Preoperative Chemotherapymentioning

confidence: 99%

Chemotherapy prior to Hepatic Resection for Colorectal Liver Metastases: Helpful until Harmful?

Abdalla

Vauthey

2008

Dig Surg

View full text Add to dashboard Cite

Background: Improved efficacy of chemotherapy for treatment of colorectal liver metastases (CLM) has renewed interest in the use of systemic treatment as part of a ‘potentially curative’ treatment plan for patients with CLM. Controversy exists regarding potential hepatotoxicity of therapy delivered before liver resection. Methods: Medline reports of pathologic changes in liver and tumor, specific chemotherapy types and clinical outcomes were examined. Results: Hepatic steatosis without inflammation (simple steatosis) may occur with chemotherapy treatment, but hepatic resection can be performed safely even in patients with severe (>30%) steatosis. Steatohepatitis is associated with irinotecan therapy and an increased risk for liver failure and death after hepatic resection. Hepatic sinusoidal obstruction can occur with oxaliplatin treatment and appears to increase in severity with prolonged treatment (>6 cycles). Bevacizumab can be used safely when discontinued >5 weeks before liver resection. Importantly, bevacizumab decreases the incidence and severity of sinusoidal injury with oxaliplatin therapy. Pathologic response is improved with the addition of bevacizumab and is evolving as an independent predictor of long-term survival. Conclusions: Chemotherapy-related liver injuries are regimen-specific. Targeted therapy combined with cytotoxic therapy is safe and most effective. With the use of limited chemotherapy combining appropriately selected agents, the risk of surgical complications can be minimized and the overall effect and benefits of treatment optimized.

show abstract

“…In addition, different types of chemotherapy cause different patterns of injury. Specifically, oxaliplatin causes sinusoidal obstruction, whereas irinotecan causes steatohepatitis (8,15,16). However, the effect of chemotherapy-related liver injury on perioperative morbidity and mortality remains unclear, with certain studies reporting an association (15,17), unlike others (8,16).…”

Section: Discussionmentioning

confidence: 99%

Peroxisome proliferator-activated receptor-α staining is associated with worse outcome in colorectal liver metastases

Pang

Kaufman

Choi

et al. 2014

Molecular and Clinical Oncology

View full text Add to dashboard Cite

Abstract. Peroxisome proliferator-activated receptors (PPARs) are a family of nuclear receptors involved in lipid metabolism and liver response to injury. We hypothesised that differences in the expression of PPARs may reflect differences in the cellular microenvironment of the liver and, consequently, in the behaviour of colorectal liver metastases. Of the 145 patients who underwent hepatectomy for colorectal liver metastases between 1998 and 2007, 103 had adequate tissue for PPAR staining and histological re-evaluation. The histological characteristics evaluated included sinusoidal dilatation, perisinusoidal fibrosis, ballooning and steatosis. PPAR-α and -γ staining was performed and the results were correlated with clinical and survival data. Lobular inflammation and sinusoidal dilatation were the most common histopathological abnormalities. A total of 50% of the patients were PPAR-α-negative and 34% were PPAR-γ-negative. More patients exhibited lobular inflammation in the PPAR-α-positive group (P=0.023) compared to patients with negative PPAR-α staining, as seen on the multivariate analysis. PPAR-γ positivity was associated with oxaliplatin use, surgical margins ≥1 mm and a trend towards a lesser degree of fibrosis. The median follow-up in this cohort of patients was 48 months. Patients with PPAR-α staining had a worse overall survival (median, 36 vs. 79 months, P=0.037) compared to those with no PPAR-α staining. There was no correlation between PPAR-α or -γ positivity and disease-free survival. In conclusion, PPAR-α staining is associated with lobular inflammation and worse overall survival in patients with colorectal liver metastases. The exact mechanism underlying this finding remains unclear and further research into the diagnostic and therapeutic implications is required.

show abstract

Effect of preoperative chemotherapy on liver resection for colorectal liver metastases

Cited by 90 publications

References 13 publications

Accuracy of gadoxetic acid-enhanced magnetic resonance imaging for the diagnosis of sinusoidal obstruction syndrome in patients with chemotherapy-treated colorectal liver metastases

Accuracy of gadoxetic acid-enhanced magnetic resonance imaging for the diagnosis of sinusoidal obstruction syndrome in patients with chemotherapy-treated colorectal liver metastases

Chemotherapy prior to Hepatic Resection for Colorectal Liver Metastases: Helpful until Harmful?

Peroxisome proliferator-activated receptor-α staining is associated with worse outcome in colorectal liver metastases

Contact Info

Product

Resources

About