Liver Failure in patients treated with chemotherapy for colorectal liver metastases: Role of chronic disease scores in patients undergoing major liver surgery. A case-matched analysis

F. Ratti, F. Cipriani, M. Catena, M. Paganelli, L. Aldrighetti

Research output: Contribution to journalArticle

Abstract

Aim: An accurate and noninvasive tool to predict Chemotherapy Associated Liver Injury (CALI) still lacks. Study aimed to evaluate chronic liver disease scores (Aspartate aminotransferase to Platelet Ratio Index, APRI and Fibrosis-4, FIB-4) as Postoperative Liver Failure (PLF) predictors in patients treated with Oxaliplatin for Colorectal Liver Metastases (CLM). Methods: 8 patients who developed PLF after major hepatectomy (Group B) were compared to 24 patients who did not develop PLF (Group A) in a case-matched analysis for patients and disease characteristics. ROC curves analysis was performed to assess score accuracy. Results: In Group A number of CT cycles was lower, (6 vs 9, p NS), interval between treatment and surgery was longer (11 vs 7 weeks, p <0.05) and bevacizumab was more frequently administered (66.7% vs 37.5%, p <0.05). In Group B median APRI score was 0.53 (range: 0.86-4.26) whereas in Group Awas 0.30 (range: 0.06-2.21, p <0.05). Median FIB-4 score was 2.46 (range: 0.86-13.65) in Group B and 1.58 (range: 0.27-7.68) in Group A (p <0.001). Multivariate analysis showed a significant correlation between APRI and the onset of PLF. A good accuracy of APRI score was evident in ROC curves with an area under the curve of 0.72 (p 0.003). Conclusions: APRI score is calculated considering both liver damage and platelet count, it is cost effective and easily available. This study demonstrates that there is a good accuracy in PLF prediction and consequently in CT induced liver damage evaluation.

Original languageEnglish
Pages (from-to)1550-1556
Number of pages7
JournalEuropean Journal of Surgical Oncology
Volume40
Issue number11
DOIs
Publication statusPublished - 2014

Keywords

  • Chemotherapy
  • Liver surgery
  • Metastases
  • Postoperative Liver Failure
  • Sinusoidal obstruction

ASJC Scopus subject areas

  • Oncology
  • Surgery
  • Medicine(all)

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