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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 13/2012

Open Access 01-12-2012 | Hepatobiliary Tumors

Chemotherapy-Associated Liver Injury in Patients with Colorectal Liver Metastases: A Systematic Review and Meta-analysis

Authors: Stuart M. Robinson, MRCS, Colin H. Wilson, PhD, FRCS, Alastair D. Burt, MD, FRCPath, FRCP, Derek M. Manas, FRCS, Steven A. White, MD, FRCS

Published in: Annals of Surgical Oncology | Issue 13/2012

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Abstract

Background

Chemotherapy-associated liver injury is a major cause for concern when treating patients with colorectal liver metastases. The aim of this review was to determine the pathological effect of specific chemotherapy regimens on the hepatic parenchyma as well as on surgical morbidity, mortality and overall survival.

Methods

A systematic review of the published literature and a meta-analysis were performed. For each of the variables under consideration, the effects of different chemotherapy regimens were determined by calculation of relative risks by a random-effects model.

Results

Hepatic parenchymal injury is regimen specific, with oxaliplatin-based regimens being associated with grade 2 or greater sinusoidal injury (number needed to harm 8; 95 % confidence interval [CI] 6.4–13.6), whereas irinotecan-based regimens associated with steatohepatitis (number needed to harm 12; 95 % CI 7.8–26). The use of bevacizumab alongside FOLFOX reduces the risk of grade 2 or greater sinusoidal injury (relative risk 0.34; 95 % CI 0.15–0.75).

Conclusions

Chemotherapy before resection of colorectal liver metastases is associated with an increased risk of regimen-specific liver injury. This liver injury may have implications for the functional reserve of the liver for patients undergoing major hepatectomy for colorectal liver metastases.
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Metadata
Title
Chemotherapy-Associated Liver Injury in Patients with Colorectal Liver Metastases: A Systematic Review and Meta-analysis
Authors
Stuart M. Robinson, MRCS
Colin H. Wilson, PhD, FRCS
Alastair D. Burt, MD, FRCPath, FRCP
Derek M. Manas, FRCS
Steven A. White, MD, FRCS
Publication date
01-12-2012
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 13/2012
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-012-2438-8

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