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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 1/2011

01-01-2011 | Gastrointestinal Oncology

Chemotherapy-Associated Liver Injury: Impact on Surgical Management of Colorectal Cancer Liver Metastases

Authors: Peter J. Kneuertz, MD, Shishir K. Maithel, MD, Charles A. Staley, MD, David A. Kooby, MD

Published in: Annals of Surgical Oncology | Issue 1/2011

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Abstract

Chemotherapy is integral to the management of patients with advanced colorectal cancer liver metastases. Due to their improved efficacy, modern regimens can sometimes convert unresectable disease to a resectable state. As chemotherapy is often administered prior to hepatic resection, adverse effects on the liver are increasingly being recognized. Investigators have identified a wide spectrum of effects on the underlying liver parenchyma, ranging from mild forms of steatosis to severe steatohepatitis and sinusoidal obstruction syndrome. As the histopathologic definitions of these changes evolve, studies have identified specific patterns of hepatic injury related to the various chemotherapeutic agents. The impact of these changes on perioperative outcome after partial hepatectomy remains controversial. Timing and duration of chemotherapy may play a key role and account for discrepancies in outcomes seen among studies. In this review, we provide an overview of the spectrum of chemotherapy-associated liver injury and discuss its relevance to perioperative management of patients undergoing hepatic resection of colorectal cancer liver metastases.
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Metadata
Title
Chemotherapy-Associated Liver Injury: Impact on Surgical Management of Colorectal Cancer Liver Metastases
Authors
Peter J. Kneuertz, MD
Shishir K. Maithel, MD
Charles A. Staley, MD
David A. Kooby, MD
Publication date
01-01-2011
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 1/2011
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-010-1201-2

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