Severe hepatic sinusoidal obstruction associated with oxaliplatin-based chemotherapy in patients with metastatic colorectal cancer

Rubbia‐Brandt, Laura; Audard, Vincent; Sartoretti, P.; Roth, Arnaud; Brézault, Catherine; Charpentier, M. Le; Dousset, B.; Morel, Philippe; Soubrane, Olivier; Chaussade, Stanislas; Mentha, Gilles; Terris, Benoı̂t

doi:10.1093/annonc/mdh095

Cited by 944 publications

(747 citation statements)

References 26 publications

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“…Histological analysis of the FLR displayed hepatocyte mitosis and hepatic sinusoidal injury characterized by sinusoidal dilatation, microvesicular steatosis, hepatocellular atrophy, and centrilobular or perisinusoidal fibrosis16. These microscopic changes were most pronounced in the ALPPS30 group on days 1–3, and in ALPPS20, ALPPS10 and PVL groups on days 1–7, but were not notable in either the LLL or the control group at any time point.…”

Section: Resultsmentioning

confidence: 94%

Experimental evaluation of liver regeneration patterns and liver function following ALPPS

et al. 2017

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BackgroundThe underlying mechanism of liver regeneration after Associating Liver Partition and Portal vein ligation (PVL) for Staged hepatectomy (ALPPS) is still unclear. The aim of this study was to evaluate the relationship between future liver remnant (FLR) volume, liver regeneration characteristics and restoration of function in an experimental model of ALPPS.MethodsAn ALPPS model in rats was developed with selective PVL, parenchymal transection and partial hepatectomy (step 1), followed by resection of the liver (step 2). Three different ALPPS groups with FLR sizes of 30, 20 and 10 per cent of total liver volume were compared with sham‐operated controls and animals undergoing resection of left lateral lobe and 90 per cent PVL with respect to morbidity, mortality, liver regeneration and function.ResultsThree of 15 animals that had ALPPS with 10 per cent FLR (ALPPS10) died after step 1. Ascites developed in two of five rats that had ALPPS with 20 per cent FLR and in three of four animals in the ALPPS10 group after step 2. Although the relative increments in FLR size and growth rates were highest in the ALPPS groups, small FLR size was associated with a sustained increase in levels of serum aminotransferases and bilirubin, a lower albumin concentration, severe sinusoidal injury, increased expression of proliferation markers and increased activation of hepatic progenitor cells after step 2.ConclusionThere is discordance between FLR volume increase and functional restoration after the ALPPS procedure.

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Section: Resultsmentioning

confidence: 94%

Experimental evaluation of liver regeneration patterns and liver function following ALPPS

et al. 2017

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“…As the use of neoadjuvant therapy has increased, so has the concern about possible long-term adverse effects of chemotherapy, particularly on the liver, where there is some evidence of vascular changes (Rubbia-Brandt et al, 2004;Adam et al, 2005) and steatohepatitis (Fernandez et al, 2005) following chemotherapy. However, although the vascular changes may increase the risk of intraoperative bleeding, it is not thought that they have any significant clinical impact (Adam et al, 2005).…”

Section: Discussionmentioning

confidence: 99%

Final analysis of colorectal cancer patients treated with irinotecan and 5-fluorouracil plus folinic acid neoadjuvant chemotherapy for unresectable liver metastases

et al. 2007

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We have previously reported that neoadjuvant therapy with modified FOLFIRI enabled nearly a third of patients with metastatic colorectal cancer (mCRC) to undergo surgical resection of liver metastases. Here, we present data from the long-term follow-up of these patients. Forty patients received modified FOLFIRI: irinotecan 180 mg m À2 , day 1; folinic acid, 200 mg m À2 ; and 5-fluorouracil: as a 400 mg m À2 bolus, days 1 and 2, and a 48-h continuous infusion 1200 mg m À2 , from day 1. Treatment was repeated every 2 weeks, with response assessed every six cycles. Resected patients received six further cycles of chemotherapy postoperatively. Nineteen (47.5%) of 40 patients achieved an objective response; 13 (33%) underwent resection. After a median follow-up of 56 months, median survival for all patients was 31.5 months: for non-resected patients, median survival was 24 months and was not reached for resected patients. Median time to progression was 14.3 and 5.2 months for all and non-resected patients, respectively. Median disease-free (DF) survival in resected patients was 52.5 months. At 2 years, all patients were alive (8 DF), and at last follow-up, eight were alive (6 DF). Surgical resection of liver metastases after neoadjuvant treatment with modified FOLFIRI in CRC patients achieved favourable survival times.

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“…In recent years, treatment with curative intent is actively performed by making modifications to liver resection and perioperative chemotherapy for unresectable liver metastases,96, 97 which has increased awareness of the utility of LLR as part of multidisciplinary therapy. Chemotherapy administered before liver resection may cause liver damage98, 99 and is considered disadvantageous for LLR. However, LLR can still be performed safely if the surgeon understands the pharmacological profile of the chemotherapeutic agents, chooses appropriate surgical instruments, and perform the proper surgical maneuvers 100.…”

Section: Indications and Oncological Outcomesmentioning

confidence: 99%

Evolution and revolution of laparoscopic liver resection in Japan

Kaneko

Otsuka

Kubota

et al. 2017

Annals of Gastroent Surgery

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Due to important technological developments and improved endoscopic techniques, laparoscopic liver resection (LLR) is now considered the approach of choice and is increasingly performed worldwide. Recent systematic reviews and meta‐analyses of observational data reported that LLR was associated with less bleeding, fewer complications, and no oncological disadvantage; however, no prospective randomized trials have been conducted. LLR will continue to evolve as a surgical approach that improves patient's quality of life. LLR will not totally supplant open liver surgery, and major LLR remains to be technically challenging procedure. The success of LLR depends on individual learning curves and adherence to surgical indications. A recent study proposed a scoring system for stepwise application of LLR, which was based on experience at high‐volume Japanese centers. A cluster of deaths after major LLR was sensationally reported by the Japanese media in 2014. In response, the Japanese Society of Hepato‐Biliary‐Pancreatic Surgery conducted emergency data collection on operative mortality. The results demonstrated that mortality was not higher than that for open procedures except for hemi‐hepatectomy with biliary reconstruction. An online prospective registry system for LLR was established in 2015 to be transparent for patients who might potentially undergo treatment with this newly developed, technically demanding surgical procedure.

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Severe hepatic sinusoidal obstruction associated with oxaliplatin-based chemotherapy in patients with metastatic colorectal cancer

Cited by 944 publications

References 26 publications

Experimental evaluation of liver regeneration patterns and liver function following ALPPS

Experimental evaluation of liver regeneration patterns and liver function following ALPPS

Final analysis of colorectal cancer patients treated with irinotecan and 5-fluorouracil plus folinic acid neoadjuvant chemotherapy for unresectable liver metastases

Evolution and revolution of laparoscopic liver resection in Japan

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