Autotaxin is a novel surrogate marker for oxaliplatin‐related sinusoidal obstruction syndrome in patients with colorectal liver metastasis

Abstract

Background: Chemotherapy for colorectal liver metastasis (CRLM) has improved dramatically over the past few decades. However, sinusoidal obstruction syndrome (SOS) induced by oxaliplatin leads to increased severe morbidity after hepatectomy for CRLM. Autotaxin is a novel liver fibrosis marker known to be taken up and metabolized by sinusoidal endothelial cells. This study aimed to evaluate whether autotaxin levels could be a novel surrogate marker of SOS for CRLM. Methods:We retrospectively evaluated 73 consecutive patients who underwent hepatectomy for CRLM, and assessed the relationship between their preoperative autotaxin levels and SOS.Results: Median autotaxin level was 0.750 mg/L. Preoperative oxaliplatin-based chemotherapy for CRLM was administered to 51 patients, and SOS was histologically observed in 45 patients. Patients who received the oxaliplatin-based chemotherapy had significantly higher autotaxin levels than those who did not (p = 0.038). Furthermore, autotaxin levels were higher in patients with SOS than in those without (p = 0.011). Univariate and multivariate analyses revealed that autotaxin level can be an independent predictive factor for SOS preoperatively (p = 0.001). Conclusions:Autotaxin level is a noninvasive and promising surrogate marker for predicting SOS before surgical resection for CRLM. K E Y W O R D Sautotaxin, blue liver, chemotherapy, colorectal liver metastasis, liver fibrosis, oxaliplatin, sinusoidal obstruction syndrome gery not only for resectable CRLM but also conversion surgery for unresectable CRLM. 3,4 However, chemotherapeutic damage to the non-neoplastic liver has been reported, in particular liver injury Abbreviations: APRI, aspartate aminotransferase platelet ratio index; ATX, autotaxin; CRLM, colorectal liver metastasis; FIB-4, fibrosis-4; HCC, hepatocellular carcinoma; SOS, sinusoidal obstruction syndrome.