Systematic review of the influence of chemotherapy-associated liver injury on outcome after partial hepatectomy for colorectal liver metastases

Abstract

An increase in postoperative major morbidity and liver surgery-specific complications was observed after partial hepatectomy in patients with severe SD and steatohepatitis. Postoperative liver failure occurred more often in patients with severe SD.

Current topics in liver surgery

“…In contrast, steatohepatitis is known to increase the risk of postoperative mortality when the patient receives more than 7.5 cycles of chemotherapy. Body mass index is one surrogate marker for high risk of hepatic steatohepatitis …”

“…Rate of increase in splenic volume and decrease in platelet count are predictive of SOS . Reportedly, 75% of patients who received adjuvant chemotherapy had increased splenic volume and 40% of patients did not recover after discontinuation of chemotherapy . Giving bevacizumab in combination with systemic chemotherapy reduces the occurrence of SOS .…”

Treatment sequencing for simultaneous colorectal liver metastases

“…Vauthey et al 49 with steatohepatitis undergoing partial hepatectomy. 52 The same authors did not find an association between irinotecan chemotherapy use and steatohepatitis, however. In the same study, severe sinusoidal dilation, associated with oxaliplatin use, was also associated with major complications (OR, 1.73; 95% CI, 1.02-2.95).…”

“…In contrast, Masi et al showed no deaths within 90 days in patients treated with preoperative FOLFOXIRI for a median of 22 weeks. A recent 8‐study pooled analysis showed increased odds (adjusted odds ratio [OR], 2.08; 95% confidence interval [CI], 1.18‐3.66) of liver‐specific complications (ascites, postoperative liver failure, bile leak, intra‐abdominal abscess, and bleeding) for patients with steatohepatitis undergoing partial hepatectomy . The same authors did not find an association between irinotecan chemotherapy use and steatohepatitis, however.…”

Disappearing colorectal liver metastases: Strategies for the management of patients achieving a radiographic complete response after systemic chemotherapy

“…39 Although steatosis and sinusoidal dilation increases morbidity risk from bleeding and biliary fistulas, there are conflicting data as to whether sinusoidal damage or steatosis (and steatohepatitis) increase the risk of perioperative mortality after resection of CRLM. 34,35,40,41…”