Extent of hepatic resection does not correlate with toxicity following adjuvant chemotherapy Journal Article


Authors: Carlo, W.; Hummer, A. J.; Schwartz, L.; Sullivan, D.; Gonen, M.; Jarnagin, W.; Fong, Y.; Kemeny, N.
Article Title: Extent of hepatic resection does not correlate with toxicity following adjuvant chemotherapy
Abstract: Background: In patients with liver metastases from colorectal cancer, survival can be increased by hepatic resection. Treatment with hepatic arterial infusion (HAI) and systemic chemotherapy following resection may further increase survival and decrease recurrence, but may also result in hepatic and systemic toxicity. This article will address the question of whether large hepatic resections resulting in a greater loss of healthy liver predisposes patients to developing toxicity from the subsequent chemotherapeutic regimens. Design: Retrospective analysis of 88 patients who underwent liver resection of colorectal metastases followed by adjuvant HAI and systemic chemotherapy and whose computerized tomography (CT) scans were done at Memorial Sloan-Kettering Cancer Center (MSKCC). Liver volumes were calculated from CT scans and used to determine the percentage change in healthy liver volume between the pre- and postoperative CT scans. Hepatic and systemic toxicities were defined according to the Common Toxicity Criteria of the National Cancer Institute. Results: Patients experienced a mean percentage decrease in healthy liver tissue of 17% (range: 57% decrease to 32% increase) at an estimated 1 month after resection and at the initiation of chemotherapy. In a logistic regression model using percentage change in the healthy liver volume as a continuous variable, no significant association was revealed between percentage of healthy liver resected and diarrhea (P = 0.47), leukopenia (P = 0.37), neutropenia (P = 0.31), high bilirubin (P = 0.27), or alkaline phosphatase (P = 0.79). Conclusions: A greater loss of healthy liver following resection of hepatic metastases from colorectal cancer does not seem to predispose to the development of toxicity from adjuvant HAI and systemic chemotherapy. © 2004 Wiley-Liss, Inc.
Keywords: adult; controlled study; middle aged; retrospective studies; major clinical study; disease course; neutropenia; postoperative period; fluorouracil; diarrhea; liver neoplasms; chemotherapy, adjuvant; antineoplastic agent; preoperative evaluation; computer assisted tomography; leukopenia; antineoplastic combined chemotherapy protocols; drug administration schedule; camptothecin; dexamethasone; drug effect; pathology; retrospective study; irinotecan; colorectal carcinoma; colorectal neoplasms; alkaline phosphatase; bilirubin; liver metastasis; liver; correlation analysis; chemically induced disorder; colorectal tumor; folinic acid; adjuvant chemotherapy; liver tumor; drug derivative; intraarterial drug administration; infusions, intra-arterial; liver resection; hepatectomy; alkaline phosphatase blood level; hyperbilirubinemia; drug administration; toxicity; disease predisposition; logistic regression analysis; leucovorin; drug induced disease; hepatic artery; hepatic arterial infusion; liver size; liver circulation; humans; human; male; female; priority journal; article; liver volumes
Journal Title: Journal of Surgical Oncology
Volume: 87
Issue: 2
ISSN: 0022-4790
Publisher: Wiley Blackwell  
Date Published: 2004-08-01
Start Page: 85
End Page: 90
Language: English
DOI: 10.1002/jso.20074
PROVIDER: scopus
PUBMED: 15282702
DOI/URL:
Notes: J. Surg. Oncol. -- Cited By (since 1996):8 -- Export Date: 16 June 2014 -- CODEN: JSONA -- Source: Scopus
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Citation Impact
MSK Authors
  1. Amanda J Hummer
    60 Hummer
  2. Mithat Gonen
    785 Gonen
  3. Lawrence H Schwartz
    282 Schwartz
  4. William R Jarnagin
    654 Jarnagin
  5. Yuman Fong
    772 Fong
  6. Nancy Kemeny
    438 Kemeny
  7. Waldemar   Carlo
    1 Carlo