Prevalence and clinical relevance of pathological hepatic changes occurring after neoadjuvant chemotherapy for colorectal liver metastases.

Détails

ID Serval
serval:BIB_8EF34DE74B5A
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Prevalence and clinical relevance of pathological hepatic changes occurring after neoadjuvant chemotherapy for colorectal liver metastases.
Périodique
Surgery
Auteur(s)
Hubert C., Fervaille C., Sempoux C., Horsmans Y., Humblet Y., Machiels J.P., Zech F., Ceratti A., Gigot J.F.
ISSN
1532-7361 (Electronic)
ISSN-L
0039-6060
Statut éditorial
Publié
Date de publication
2010
Peer-reviewed
Oui
Volume
147
Numéro
2
Pages
185-194
Langue
anglais
Notes
Publication types: Journal Article Publication Status: ppublish
Résumé
BACKGROUND: Hepatotoxicity from neoadjuvant chemotherapy before liver resection for colorectal metastases (CRLM) has been recently reported. The purpose of the present study was to evaluate the prevalence and the clinical relevance of this phenomenon. It was a retrospective study conducted at an academic secondary referral hospital.
METHODS: One hundred patients suffering from CRLM and having undergone the resection of at least 1 liver segment (114 hepatectomies; 100 first, 13 second, 1 third) were enrolled. The surgical specimens were reviewed using standardized criteria for diagnosis and grading of pathological liver changes. Their impact on perioperative bleeding, transfusion, morbidity, and mortality rates after liver resection was studied.
RESULTS: Sinusoidal congestion was the single hepatotoxic lesion significantly more frequently encountered in patients having received neoadjuvant chemotherapy (P = .0014), even in patients having received chemotherapy more than 6 months before liver resection, but was not related to the type of chemotherapy. Despite a significant increase in perioperative blood losses, the presence of sinusoidal lesions, even severe, had no clinically significant effect on postoperative mortality, morbidity, and transfusion rates.
CONCLUSION: Neoadjuvant chemotherapy before operation for CRLM is significantly associated to sinusoidal congestion, irrespective of the type of chemotherapy but without any significant impact on postoperative clinical outcome. Sinusoidal lesions may persist more than 6 months after the end of chemotherapy.
Mots-clé
Adolescent, Adult, Aged, Aged, 80 and over, Antineoplastic Combined Chemotherapy Protocols/adverse effects, Antineoplastic Combined Chemotherapy Protocols/therapeutic use, Colorectal Neoplasms/pathology, Female, Hepatectomy, Humans, Liver/drug effects, Liver/pathology, Liver Neoplasms/drug therapy, Liver Neoplasms/pathology, Male, Middle Aged, Neoadjuvant Therapy, Young Adult
Pubmed
Web of science
Création de la notice
29/01/2015 13:33
Dernière modification de la notice
03/03/2018 19:20
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