BACKGROUND/AIMS: In patients with colorectal cancer liver metastases (CRCLM), chemotherapy-associated hepatotoxicity (CAH) has been shown to be associated with splenomegaly. The aim of the present study was to investigate whether a higher splenic volume increase (SVI) after preoperative chemotherapy was associated with a worse long-term outcome after hepatectomy in patients with CRCLM. METHODOLOGY: Between 2007 and 2012, there were 36 patients who received preoperative chemotherapy based on a diagnosis of initially non-optimally resectable synchronous CRCLM. The splenic volume was measured by CT-volumetry before preoperative chemotherapy and 12 weeks after the start of the chemotherapy. Long-term outcome was analyzed in these patients. RESULTS: The overall survival was significantly shorter in the SVI ≥30% group than in the SVI <30% group (3-year survival = 52% vs. 28%, p <0.05). The disease-free survival was also significantly shorter in the SVI ≥30% group than in the SVI <30% group (Median = 11 vs. 6 months, p <0.05). The survival after recurrence was significantly shorter in the SVI ≥30% group than in the SVI <30% group (Median = 12.0 vs. 18 months, p<0.05). CONCLUSIONS: In patients with non-optimally resectable CRCLM, the SVI during the first 12 weeks of preoperative chemotherapy may be a significant predictor of the long-term survival after hepatectomy.
BACKGROUND/AIMS: In patients with colorectal cancer liver metastases (CRCLM), chemotherapy-associated hepatotoxicity (CAH) has been shown to be associated with splenomegaly. The aim of the present study was to investigate whether a higher splenic volume increase (SVI) after preoperative chemotherapy was associated with a worse long-term outcome after hepatectomy in patients with CRCLM. METHODOLOGY: Between 2007 and 2012, there were 36 patients who received preoperative chemotherapy based on a diagnosis of initially non-optimally resectable synchronous CRCLM. The splenic volume was measured by CT-volumetry before preoperative chemotherapy and 12 weeks after the start of the chemotherapy. Long-term outcome was analyzed in these patients. RESULTS: The overall survival was significantly shorter in the SVI ≥30% group than in the SVI <30% group (3-year survival = 52% vs. 28%, p <0.05). The disease-free survival was also significantly shorter in the SVI ≥30% group than in the SVI <30% group (Median = 11 vs. 6 months, p <0.05). The survival after recurrence was significantly shorter in the SVI ≥30% group than in the SVI <30% group (Median = 12.0 vs. 18 months, p<0.05). CONCLUSIONS: In patients with non-optimally resectable CRCLM, the SVI during the first 12 weeks of preoperative chemotherapy may be a significant predictor of the long-term survival after hepatectomy.
Authors: Amber L Simpson; Julie N Leal; Amudhan Pugalenthi; Peter J Allen; Ronald P DeMatteo; Yuman Fong; Mithat Gönen; William R Jarnagin; T Peter Kingham; Michael I Miga; Jinru Shia; Martin R Weiser; Michael I D'Angelica Journal: J Am Coll Surg Date: 2014-12-13 Impact factor: 6.113