Back to Search
Start Over
Histological features and severity of oxaliplatin-induced liver injury and clinical associations.
Histological features and severity of oxaliplatin-induced liver injury and clinical associations.
- Source :
-
Journal of digestive diseases [J Dig Dis] 2014 Oct; Vol. 15 (10), pp. 553-60. - Publication Year :
- 2014
-
Abstract
- Objective: Oxaliplatin, a component of chemotherapy for colorectal carcinoma liver metastases, can result in hepatic sinusoidal injury; rarely, the injury is fatal. The manifestations of injury are variable. There are no known predictors of susceptibility and outcome. A semi-quantitative system for assessing histological features in non-tumor liver was designed to compare with clinical short-term and long-term outcomes.<br />Methods: A review of 47 patients with metastatic colorectal carcinoma who received liver resection utilizing a system for an aggregate liver injury score (0-4) included hepatocellular and sinusoidal features. Immunohistochemistry (IHC) for aberrant capillarization was included. The proliferation of hepatocytes and sinusoidal lining cells was evaluated with Ki-67 stain.<br />Results: In total, 32 (68.1%) cases showed light microscopic lesions of oxaliplatin-induced liver injury, in which 26 were moderate to severe. Elevated preoperative aspartate aminotransferase (AST) and alkaline phosphatase levels were noted with higher injury scores (P = 0.01). Patients with higher injury scores had no significant increase in short-term postoperative complications, with one notable exception, who died of liver failure 10 months postoperatively. Increased CD34 expression was associated with higher injury scores (P = 0.00004), and abnormal AST levels (P = 0.04). Preoperative use of bevacizumab was not associated with lower injury scores. Steatosis was correlated with body mass index (P = 0.052) but not with exposure to oxaliplatin, bevacizumab or irinotecan.<br />Conclusions: The proposed liver injury scoring system encompasses the spectrum of sinusoidal and hepatocellular lesions in oxaliplatin-induced liver injury and is correlated with serum liver enzyme levels in this group. Most patients recovered without complications during the 93-month follow-up, indicating that these lesions are reversible.<br /> (© 2014 Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine and Wiley Publishing Asia Pty Ltd.)
- Subjects :
- Antineoplastic Agents therapeutic use
Chemical and Drug Induced Liver Injury etiology
Chemotherapy, Adjuvant adverse effects
Colorectal Neoplasms pathology
Female
Hepatectomy
Hepatocytes pathology
Humans
Liver Neoplasms drug therapy
Liver Neoplasms secondary
Liver Neoplasms surgery
Male
Neoadjuvant Therapy adverse effects
Organoplatinum Compounds therapeutic use
Oxaliplatin
Retrospective Studies
Severity of Illness Index
Antineoplastic Agents adverse effects
Chemical and Drug Induced Liver Injury pathology
Organoplatinum Compounds adverse effects
Subjects
Details
- Language :
- English
- ISSN :
- 1751-2980
- Volume :
- 15
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- Journal of digestive diseases
- Publication Type :
- Academic Journal
- Accession number :
- 25060628
- Full Text :
- https://doi.org/10.1111/1751-2980.12177