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Histological liver injury and surgical outcome after FOLFOX followed by a hepatectomy for colorectal liver metastases in Japanese patients

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Abstract

Background

This study was performed to clarify the influence of preoperative chemotherapy on liver function and the correlation between histological hepatic injury and the postoperative outcome in patients with colorectal liver metastases who underwent a hepatic resection.

Methods

Twenty-seven patients who underwent a hepatic resection for colorectal liver metastases were included. Fifteen patients with initially unresectable colorectal liver metastases who were able to undergo a tumor resection after FOLFOX (oxaliplatin plus fluorouracil and leucovorin, with a mean number of 7.7 cycles) were compared to 12 patients who underwent a hepatectomy with no preoperative chemotherapy. The postoperative mortality, morbidity, changes in liver function tests, and pathology of the resected liver were examined.

Results

Preoperative FOLFOX therapy was significantly associated with the macroscopic appearance of oxaliplatin-associated blue liver (p = 0.02), and a tendency toward sinusoidal dilatation (33.3% in the FOLFOX group versus 8.3% in the no-chemotherapy group, p = 0.056). Preoperative liver function tests showed that the albumin and indocyanine green retention rate at 15 min (ICG-R15) test values were significantly worse after FOLFOX therapy; however, intraoperative events, postoperative liver function test values, and morbidity rates were similar in the two groups. There was no postoperative mortality in any of the patients.

Conclusions

Although preoperative FOLFOX administration in patients with colorectal liver metastases caused macroscopic blue liver, microscopic sinusoidal dilatationin the liver parenchyma, and a significant decrease in liver function, there was no increase in the morbidity and mortality rates, in comparison to findings in patients without preoperative chemotherapy.

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Abbreviations

FU:

Fluorouracil

LV:

Leucovorin

FOLFOX:

Chemotherapy with oxaliplatin plus fluorouracil and leucovorin

FOLFIRI:

Chemotherapy with CPT-11 plus fluorouracil and leucovorin

NAFLD:

Nonalcoholic fatty liver disease

NASH:

Nonalcoholic steatohepatitis

L-OHP:

Oxaliplatin

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Conflict of interest statement

Hideo Baba received lecture fees and research funding from Yakult Honsha. The other authors have no conflicts of interest.

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Authors and Affiliations

  1. Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjyo, Kumamoto, 860-8556, Japan

    Hiroyuki Komori, Toru Beppu, Yoshifumi Baba, Kei Horino, Choi Imsung, Toshiro Masuda, Hiromitsu Hayashi, Hirohisa Okabe, Ryuu Ootao, Masayuki Watanabe, Hiroshi Takamori & Hideo Baba

  2. Department of Surgical Pathology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjyo, Kumamoto, 860-8556, Japan

    Kenichi Iyama

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  1. Hiroyuki Komori
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  2. Toru Beppu
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  3. Yoshifumi Baba
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Correspondence to Hideo Baba.

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Komori, H., Beppu, T., Baba, Y. et al. Histological liver injury and surgical outcome after FOLFOX followed by a hepatectomy for colorectal liver metastases in Japanese patients. Int J Clin Oncol 15, 263–270 (2010). https://doi.org/10.1007/s10147-010-0046-9

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  • DOI: https://doi.org/10.1007/s10147-010-0046-9

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