TY - JOUR
T1 - Impact of chemotherapy-associated liver injury on tumour regression grade and survival in patients with colorectal liver metastases
AU - Zhao, Junfang
AU - Sawo, Pamir
AU - Rensen, Sander S.
AU - Rouflart, Margriet M. J.
AU - Winstanley, Alison
AU - Vreuls, Celien P. H.
AU - Verheij, Joanne
AU - van Mierlo, Kim M. C.
AU - Lodewick, Toine M.
AU - van Woerden, Victor
AU - van Tiel, Frank H.
AU - van Dam, Ronald M.
AU - Dejong, Cornelis H. C.
AU - Damink, Steven W. M. Olde
PY - 2018/2
Y1 - 2018/2
N2 - Background: An inverse relation between chemotherapy-associated liver injury (CALI) and tumour response to chemotherapy has been reported. The aim was to validate these findings, and further investigate the impact of CALI on survival in patients who underwent partial hepatectomy for colorectal liver metastases (CRLM).Methods: Patients who received neoadjuvant chemotherapy and underwent partial hepatectomy for CRLM between 2008 and 2014 were included. Liver and tumour specimens were histologically examined for CALI (steatosis, steatohepatitis, sinusoidal dilatation [SD], nodular regeneration) and tumour regression grade (TRG). TRG 1-2 was defined as complete tumour response.Results: 166 consecutive patients were included with a median survival of 30 and 44 months for recurrence-free and overall survival, respectively. Grade 2-3 SD was found in 44 (27%) and TRG 1-2 was observed in 33 (20%) patients. Of studied CALI, only grade 2-3 SD was associated with increased TRG 3-5 (odds ratio 3.99, 95% CI 1.17-13.65, p = 0.027). CALI was not significantly related to survival. TRG 1-2 was associated with prolonged recurrence-free (hazard ratio 0.47, 95% CI 0.25-0.89, p = 0.020) and overall survival (hazard ratio 0.35, 95% CI 0.18-0.68, p = 0.002).Conclusion: CALI was not directly related to survival. CALI was, however, associated with diminished complete tumour response, and diminished complete tumour response, in turn, was associated with decreased survival.
AB - Background: An inverse relation between chemotherapy-associated liver injury (CALI) and tumour response to chemotherapy has been reported. The aim was to validate these findings, and further investigate the impact of CALI on survival in patients who underwent partial hepatectomy for colorectal liver metastases (CRLM).Methods: Patients who received neoadjuvant chemotherapy and underwent partial hepatectomy for CRLM between 2008 and 2014 were included. Liver and tumour specimens were histologically examined for CALI (steatosis, steatohepatitis, sinusoidal dilatation [SD], nodular regeneration) and tumour regression grade (TRG). TRG 1-2 was defined as complete tumour response.Results: 166 consecutive patients were included with a median survival of 30 and 44 months for recurrence-free and overall survival, respectively. Grade 2-3 SD was found in 44 (27%) and TRG 1-2 was observed in 33 (20%) patients. Of studied CALI, only grade 2-3 SD was associated with increased TRG 3-5 (odds ratio 3.99, 95% CI 1.17-13.65, p = 0.027). CALI was not significantly related to survival. TRG 1-2 was associated with prolonged recurrence-free (hazard ratio 0.47, 95% CI 0.25-0.89, p = 0.020) and overall survival (hazard ratio 0.35, 95% CI 0.18-0.68, p = 0.002).Conclusion: CALI was not directly related to survival. CALI was, however, associated with diminished complete tumour response, and diminished complete tumour response, in turn, was associated with decreased survival.
KW - SINUSOIDAL OBSTRUCTION SYNDROME
KW - NODULAR REGENERATIVE HYPERPLASIA
KW - LONG-TERM-SURVIVAL
KW - PORTAL-VEIN EMBOLIZATION
KW - VENOOCCLUSIVE DISEASE
KW - SYNDROME SOS
KW - OXALIPLATIN
KW - SURGERY
KW - CANCER
KW - COMPLICATIONS
U2 - 10.1016/j.hpb.2017.08.030
DO - 10.1016/j.hpb.2017.08.030
M3 - Article
C2 - 28969959
SN - 1365-182X
VL - 20
SP - 147
EP - 154
JO - HPB
JF - HPB
IS - 2
ER -