Chemotherapy prior to Hepatic Resection for Colorectal Liver Metastases

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dc.contributor.author Vauthey, Nicolas
dc.contributor.author Abdalla, Eddie
dc.date.accessioned 2015-11-16T12:57:50Z
dc.date.available 2015-11-16T12:57:50Z
dc.date.copyright 2008
dc.date.issued 2015-11-16
dc.identifier.issn 0253-4886 en_US
dc.identifier.uri http://hdl.handle.net/10725/2586
dc.description.abstract Background: Improved efficacy of chemotherapy for treatment of colorectal liver metastases (CLM) has renewed interest in the use of systemic treatment as part of a ‘potentially curative’ treatment plan for patients with CLM. Controversy exists regarding potential hepatotoxicity of therapy delivered before liver resection. Methods: Medline reports of pathologic changes in liver and tumor, specific chemotherapy types and clinical outcomes were examined. Results: Hepatic steatosis without inflammation (simple steatosis) may occur with chemotherapy treatment, but hepatic resection can be performed safely even in patients with severe (>30%) steatosis. Steatohepatitis is associated with irinotecan therapy and an increased risk for liver failure and death after hepatic resection. Hepatic sinusoidal obstruction can occur with oxaliplatin treatment and appears to increase in severity with prolonged treatment (>6 cycles). Bevacizumab can be used safely when discontinued >5 weeks before liver resection. Importantly, bevacizumab decreases the incidence and severity of sinusoidal injury with oxaliplatin therapy. Pathologic response is improved with the addition of bevacizumab and is evolving as an independent predictor of long-term survival. Conclusions: Chemotherapy-related liver injuries are regimen-specific. Targeted therapy combined with cytotoxic therapy is safe and most effective. With the use of limited chemotherapy combining appropriately selected agents, the risk of surgical complications can be minimized and the overall effect and benefits of treatment optimized. en_US
dc.language.iso en en_US
dc.title Chemotherapy prior to Hepatic Resection for Colorectal Liver Metastases en_US
dc.type Article en_US
dc.description.version Published en_US
dc.title.subtitle Helpful until Harmful? en_US
dc.author.school SOM en_US
dc.author.idnumber 201100945 en_US
dc.author.woa N/A en_US
dc.author.department N/A en_US
dc.description.embargo N/A en_US
dc.relation.journal Digestive surgery en_US
dc.journal.volume 25 en_US
dc.journal.issue 6 en_US
dc.article.pages 421-429 en_US
dc.identifier.doi http://dx.doi.org/10.1159/000184733 en_US
dc.identifier.ctation Abdalla, E. K., & Vauthey, J. N. (2008). Chemotherapy prior to hepatic resection for colorectal liver metastases: helpful until harmful?. Digestive surgery, 25(6), 421-429. en_US
dc.author.email eddie.abdalla@lau.edu.lb
dc.identifier.url http://www.karger.com/Article/Abstract/184733

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