Chemotherapy-Associated Hepatopathy in Korean Colorectal Cancer Liver Metastasis Patients: Oxaliplatin-Based Chemotherapy and Sinusoidal Injury
남수정, 조재영, 이혜승, 최기영, 장자준, 윤유석, 한호성, 김혜령,
소속 상세정보
남수정 ( Nam Soo-Jeong )
Seoul National University College of Medicine Department of Pathology
조재영 ( Cho Jai-Young )
Seoul National University Bundang Hospital Department of Surgery
이혜승 ( Lee Hye-Seung )
Seoul National University Bundang Hospital Department of Pathology
최기영 ( Choe Ghee-Young )
Seoul National University Bundang Hospital Department of Pathology
장자준 ( Jang Ja-June )
Seoul National University College of Medicine Department of Pathology
윤유석 ( Yoon Yoo-Seok )
Seoul National University Bundang Hospital Department of Surgery
한호성 ( Han Ho-Seong )
Seoul National University Bundang Hospital Department of Surgery
김혜령 ( Kim Hae-Ryoung )
Seoul National University Bundang Hospital Department of Pathology
KMID : 0357920120460010022
Abstract
Background: Although chemotherapy-related hepatic injury has been reported in colorectal cancer liver metastasis (CRLM) patients, the morphologic changes caused by chemotherapeutic agents and the effect of chemotherapy on postoperative outcome remain ill-defined. A comprehensive review of the morphologic changes in the post-chemotherapy non-neoplastic liver was performed and the clinical effect of preoperative chemotherapy in CRLM patients was analyzed.
Methods: Hematoxylin-eosin, Masson’s trichrome and reticulin-stained slides from non-neoplastic livers obtained from 89 CRLM patients were analyzed, and the clinicopathologic features were correlated with the status of chemotherapy exposure.
Results: Histopathologic features of sinusoidal injury (sinusoidal dilatation, centrilobular perivenular fibrosis, parenchymal extinction lesions, small vessel obliteration, and hepatocyte plate disruption) were significantly more frequent in oxaliplatin-exposed livers (p<0.05). The extent of sinusoidal dilatation was positively correlated with increasing numbers of chemotherapy cycles (p=0.022). Abnormal preoperative liver function tests were more frequently seen (p<0.05) and postoperative total bilirubin was higher in the chemotherapy group (p=0.008). Postoperative morbidity was more common in the chemotherapy group (p=0.044).
Conclusions: Sinusoidal injury is frequently seen in oxaliplatin-treated livers, and its presence, especially when extensive, should be documented in surgical pathology practice. The recognition of sinusoidal injury may provide helpful guidelines for surgeons in deciding the extent of hepatic resection.
키워드
Drug-induced liver injury; Sinusoidal injury; Liver; Colorectal neoplasm; Metastasis
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