The influence of chemotherapy-associated sinusoidal dilatation on short-term outcome after partial hepatectomy for colorectal liver metastases: A systematic review with meta-analysis

Kim M. C. van Mierlo, Junfang Zhao, Jos Kleijnen, Sander S. Rensen, Frank G. Schaap, Cornelis H. C. Dejong, Steven W. M. Olde Damink*

*Corresponding author for this work

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A Summary background data: Hepatic sinusoidal dilatation (SD) is a histopathological entity that occurs in up to 75% of patients undergoing oxaliplatin-based chemotherapy for colorectal liver metastases (CRLM). Objective: To study the influence of SD on outcome after partial hepatectomy in patients with CRLM. Methods: Medline, Embase, CENTRAL, LILACS and CINAHL were searched for studies published between 01.01.2004 and 09.06.2015 with keywords: "sinusoidal obstruction syndrome", "hepatic veno-occlusive disease", and "Stuart-Bras syndrome". Studies comprising adults who underwent partial hepatectomy for CRLM with grading of SD and registration of postoperative morbidity and/or mortality were included. Risk of bias and quality of studies were evaluated with the Quality In Prognosis Studies Instrument (QUIPS) and modified GRADE framework. Results: Search strategies produced 2007 hits from which 23 and 13 articles were extracted for qualitative and quantitative analyses, respectively. Meta-analysis on the influence of SD grade 2-3 vs. SD grade 0-1 on postoperative overall morbidity showed an odds ratio (OR) of 1.26 [95% CI 0.74, 2.15](p = 0.40), an OR of 1.03 [0.15, 6.89]( p = 0.98) for liver failure, an OR of 1.21 [0.23, 6.35](p = 0.82) for overall mortality, and an OR of 3.52 [0.31, 39.91](p = 0.31) for liver-related morbidity. QUIPS showed a low to high risk of bias for studies, and GRADE showed very low quality of evidence per outcome. Conclusions: No significant effect of SD grade 2-3 on short-term outcome after partial hepatectomy was found. However, the data on which this conclusionwas based were not very robust and therefore no solid conclusions could be drawn.
Original languageEnglish
Pages (from-to)298-307
JournalSurgical Oncology
Issue number3
Publication statusPublished - Sept 2016


  • Sinusoidal dilatation
  • Sinusoidal obstruction syndrome
  • SOS
  • Partial hepatectomy
  • Postoperative liver failure
  • Chemotherapy-associated liver injury

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