Chemotherapy regimen predicts steatohepatitis and an increase in 90-day mortality after surgery for hepatic colorectal metastases

Jean Nicolas Vauthey, Timothy M. Pawlik, Dario Ribero, Tsung Teh Wu, Daria Zorzi, Paulo M. Hoff, Henry Q. Xiong, Cathy Eng, Gregory Y. Lauwers, Mari Mino-Kenudson, Mauro Risio, Andrea Muratore, Lorenzo Capussotti, Steven A. Curley, Eddie K. Abdalla

Research output: Contribution to journalArticle

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Abstract

Purpose: Chemotherapy before resection of hepatic colorectal metastases (CRM) may cause hepatic injury and affect postoperative outcome. Patients and Methods: Four hundred six patients underwent hepatic resection of CRM between 1992 and 2005. Pathologic review of the nontumorous liver was performed using established criteria for steatosis, steatohepatitis, and sinusoidal injury. The effect of chemotherapy and liver injury on perioperative outcome was analyzed. Results: One hundred fifty-eight patients (38.9%) received no preoperative chemotherapy, whereas 248 patients (61.1 %) did. The median duration of chemotherapy was 16 weeks (range, 2 to 70 weeks). Chemotherapy consisted of fluoropyrimidine-based regimens (fluorouracil [FU] alone, 15.5%; irinotecan plus FU, 23.1 %; and oxaliplatin plus FU, 19.5%) and other therapy (3.0%). On pathologic analysis, 36 patients (8.9%) had steatosis, 34 (8.4%) had steatohepatitis, and 22 (5.4%) had sinusoidal dilation. Oxaliplatin was associated with sinusoidal dilation compared with no chemotherapy (18.9% v 1.9%, respectively; P < .001; odds ratio [OR] = 8.3; 95% CI, 2.9 to 23.6). In contrast, irinotecan was associated with steatohepatitis compared with no chemotherapy (20.2% v4.4%, respectively; P < .001; OR = 5.4; 95% CI, 2.2 to 13.5). Patients with steatohepatitis had an increased 90-day mortality compared with patients who did not have steatohepatitis (14.7% v 1.6%, respectively; P = .001; OR = 10.5; 95% CI, 2.0 to 36.4). Conclusion: Steatohepatitis is associated with an increased 90-day mortality after hepatic surgery. In patients with hepatic CRM, the chemotherapy regimen should be carefully considered because the risk of hepatotoxicity is significant.

Original languageEnglish (US)
Pages (from-to)2065-2072
Number of pages8
JournalJournal of Clinical Oncology
Volume24
Issue number13
DOIs
StatePublished - May 1 2006
Externally publishedYes

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Colorectal Surgery
Fatty Liver
Neoplasm Metastasis
Drug Therapy
irinotecan
oxaliplatin
Mortality
Liver
Fluorouracil
Odds Ratio
Dilatation
Wounds and Injuries

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Chemotherapy regimen predicts steatohepatitis and an increase in 90-day mortality after surgery for hepatic colorectal metastases. / Vauthey, Jean Nicolas; Pawlik, Timothy M.; Ribero, Dario; Wu, Tsung Teh; Zorzi, Daria; Hoff, Paulo M.; Xiong, Henry Q.; Eng, Cathy; Lauwers, Gregory Y.; Mino-Kenudson, Mari; Risio, Mauro; Muratore, Andrea; Capussotti, Lorenzo; Curley, Steven A.; Abdalla, Eddie K.

In: Journal of Clinical Oncology, Vol. 24, No. 13, 01.05.2006, p. 2065-2072.

Research output: Contribution to journalArticle

Vauthey, JN, Pawlik, TM, Ribero, D, Wu, TT, Zorzi, D, Hoff, PM, Xiong, HQ, Eng, C, Lauwers, GY, Mino-Kenudson, M, Risio, M, Muratore, A, Capussotti, L, Curley, SA & Abdalla, EK 2006, 'Chemotherapy regimen predicts steatohepatitis and an increase in 90-day mortality after surgery for hepatic colorectal metastases', Journal of Clinical Oncology, vol. 24, no. 13, pp. 2065-2072. https://doi.org/10.1200/JCO.2005.05.3074
Vauthey, Jean Nicolas ; Pawlik, Timothy M. ; Ribero, Dario ; Wu, Tsung Teh ; Zorzi, Daria ; Hoff, Paulo M. ; Xiong, Henry Q. ; Eng, Cathy ; Lauwers, Gregory Y. ; Mino-Kenudson, Mari ; Risio, Mauro ; Muratore, Andrea ; Capussotti, Lorenzo ; Curley, Steven A. ; Abdalla, Eddie K. / Chemotherapy regimen predicts steatohepatitis and an increase in 90-day mortality after surgery for hepatic colorectal metastases. In: Journal of Clinical Oncology. 2006 ; Vol. 24, No. 13. pp. 2065-2072.
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title = "Chemotherapy regimen predicts steatohepatitis and an increase in 90-day mortality after surgery for hepatic colorectal metastases",
abstract = "Purpose: Chemotherapy before resection of hepatic colorectal metastases (CRM) may cause hepatic injury and affect postoperative outcome. Patients and Methods: Four hundred six patients underwent hepatic resection of CRM between 1992 and 2005. Pathologic review of the nontumorous liver was performed using established criteria for steatosis, steatohepatitis, and sinusoidal injury. The effect of chemotherapy and liver injury on perioperative outcome was analyzed. Results: One hundred fifty-eight patients (38.9{\%}) received no preoperative chemotherapy, whereas 248 patients (61.1 {\%}) did. The median duration of chemotherapy was 16 weeks (range, 2 to 70 weeks). Chemotherapy consisted of fluoropyrimidine-based regimens (fluorouracil [FU] alone, 15.5{\%}; irinotecan plus FU, 23.1 {\%}; and oxaliplatin plus FU, 19.5{\%}) and other therapy (3.0{\%}). On pathologic analysis, 36 patients (8.9{\%}) had steatosis, 34 (8.4{\%}) had steatohepatitis, and 22 (5.4{\%}) had sinusoidal dilation. Oxaliplatin was associated with sinusoidal dilation compared with no chemotherapy (18.9{\%} v 1.9{\%}, respectively; P < .001; odds ratio [OR] = 8.3; 95{\%} CI, 2.9 to 23.6). In contrast, irinotecan was associated with steatohepatitis compared with no chemotherapy (20.2{\%} v4.4{\%}, respectively; P < .001; OR = 5.4; 95{\%} CI, 2.2 to 13.5). Patients with steatohepatitis had an increased 90-day mortality compared with patients who did not have steatohepatitis (14.7{\%} v 1.6{\%}, respectively; P = .001; OR = 10.5; 95{\%} CI, 2.0 to 36.4). Conclusion: Steatohepatitis is associated with an increased 90-day mortality after hepatic surgery. In patients with hepatic CRM, the chemotherapy regimen should be carefully considered because the risk of hepatotoxicity is significant.",
author = "Vauthey, {Jean Nicolas} and Pawlik, {Timothy M.} and Dario Ribero and Wu, {Tsung Teh} and Daria Zorzi and Hoff, {Paulo M.} and Xiong, {Henry Q.} and Cathy Eng and Lauwers, {Gregory Y.} and Mari Mino-Kenudson and Mauro Risio and Andrea Muratore and Lorenzo Capussotti and Curley, {Steven A.} and Abdalla, {Eddie K.}",
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T1 - Chemotherapy regimen predicts steatohepatitis and an increase in 90-day mortality after surgery for hepatic colorectal metastases

AU - Vauthey, Jean Nicolas

AU - Pawlik, Timothy M.

AU - Ribero, Dario

AU - Wu, Tsung Teh

AU - Zorzi, Daria

AU - Hoff, Paulo M.

AU - Xiong, Henry Q.

AU - Eng, Cathy

AU - Lauwers, Gregory Y.

AU - Mino-Kenudson, Mari

AU - Risio, Mauro

AU - Muratore, Andrea

AU - Capussotti, Lorenzo

AU - Curley, Steven A.

AU - Abdalla, Eddie K.

PY - 2006/5/1

Y1 - 2006/5/1

N2 - Purpose: Chemotherapy before resection of hepatic colorectal metastases (CRM) may cause hepatic injury and affect postoperative outcome. Patients and Methods: Four hundred six patients underwent hepatic resection of CRM between 1992 and 2005. Pathologic review of the nontumorous liver was performed using established criteria for steatosis, steatohepatitis, and sinusoidal injury. The effect of chemotherapy and liver injury on perioperative outcome was analyzed. Results: One hundred fifty-eight patients (38.9%) received no preoperative chemotherapy, whereas 248 patients (61.1 %) did. The median duration of chemotherapy was 16 weeks (range, 2 to 70 weeks). Chemotherapy consisted of fluoropyrimidine-based regimens (fluorouracil [FU] alone, 15.5%; irinotecan plus FU, 23.1 %; and oxaliplatin plus FU, 19.5%) and other therapy (3.0%). On pathologic analysis, 36 patients (8.9%) had steatosis, 34 (8.4%) had steatohepatitis, and 22 (5.4%) had sinusoidal dilation. Oxaliplatin was associated with sinusoidal dilation compared with no chemotherapy (18.9% v 1.9%, respectively; P < .001; odds ratio [OR] = 8.3; 95% CI, 2.9 to 23.6). In contrast, irinotecan was associated with steatohepatitis compared with no chemotherapy (20.2% v4.4%, respectively; P < .001; OR = 5.4; 95% CI, 2.2 to 13.5). Patients with steatohepatitis had an increased 90-day mortality compared with patients who did not have steatohepatitis (14.7% v 1.6%, respectively; P = .001; OR = 10.5; 95% CI, 2.0 to 36.4). Conclusion: Steatohepatitis is associated with an increased 90-day mortality after hepatic surgery. In patients with hepatic CRM, the chemotherapy regimen should be carefully considered because the risk of hepatotoxicity is significant.

AB - Purpose: Chemotherapy before resection of hepatic colorectal metastases (CRM) may cause hepatic injury and affect postoperative outcome. Patients and Methods: Four hundred six patients underwent hepatic resection of CRM between 1992 and 2005. Pathologic review of the nontumorous liver was performed using established criteria for steatosis, steatohepatitis, and sinusoidal injury. The effect of chemotherapy and liver injury on perioperative outcome was analyzed. Results: One hundred fifty-eight patients (38.9%) received no preoperative chemotherapy, whereas 248 patients (61.1 %) did. The median duration of chemotherapy was 16 weeks (range, 2 to 70 weeks). Chemotherapy consisted of fluoropyrimidine-based regimens (fluorouracil [FU] alone, 15.5%; irinotecan plus FU, 23.1 %; and oxaliplatin plus FU, 19.5%) and other therapy (3.0%). On pathologic analysis, 36 patients (8.9%) had steatosis, 34 (8.4%) had steatohepatitis, and 22 (5.4%) had sinusoidal dilation. Oxaliplatin was associated with sinusoidal dilation compared with no chemotherapy (18.9% v 1.9%, respectively; P < .001; odds ratio [OR] = 8.3; 95% CI, 2.9 to 23.6). In contrast, irinotecan was associated with steatohepatitis compared with no chemotherapy (20.2% v4.4%, respectively; P < .001; OR = 5.4; 95% CI, 2.2 to 13.5). Patients with steatohepatitis had an increased 90-day mortality compared with patients who did not have steatohepatitis (14.7% v 1.6%, respectively; P = .001; OR = 10.5; 95% CI, 2.0 to 36.4). Conclusion: Steatohepatitis is associated with an increased 90-day mortality after hepatic surgery. In patients with hepatic CRM, the chemotherapy regimen should be carefully considered because the risk of hepatotoxicity is significant.

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