Abstract：
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.
journal_name
Surgeryjournal_title
Surgeryauthors
Hubert C,Fervaille C,Sempoux C,Horsmans Y,Humblet Y,Machiels JP,Zech F,Ceratti A,Gigot JFdoi
10.1016/j.surg.2009.01.004subject
Has Abstractpub_date
2010-02-01 00:00:00pages
185-94issue
2eissn
0039-6060issn
1532-7361pii
S0039-6060(09)00052-Xjournal_volume
147pub_type
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