A Pathological Study of Chemotherapy-associated Liver Injury in Colorectal Hepatic Metastases

Daisuke Kudou¹⁾, Taisei Oohashi¹⁾²⁾, Harue Akasaka¹⁾²⁾, Hiroyuki Jin¹⁾²⁾, Motoi Koyama¹⁾, Yoshikazu Totoki¹⁾, Akihiko Murata¹⁾, Shunji Narumi¹⁾, Hiroshi Kijima²⁾ and Kenichi Hakamada¹⁾

Department of Surgery¹⁾ and Department of Pathology²⁾, Hirosaki University School of Medicine

Background: While chemotherapy in advanced colorectal cancer has enabled some unresectable liver metastases to made resectable, chemotherapy-associated liver injury has also been reported. We studied sinusoidal dilation and steatohepatitis in the remnant liver of colorectal liver metastasis (CLM). Patients and methods: Subjects were 48 patients who undergoing hepatic surgery for CLM from January 2004 to December 2008. We pathologically reviewed cases using established criteria for sinusoidal dilation and steatohepatitis, analyzing the effect of chemotherapy on liver injury and postoperative course. Results: Sinusoidal dilation scores were higher in the 5FU+irinotecan group (2.0±0.82) and 5FU+oxaliplatin group (1.66±0.66) than in the no-chemotherapy group (1.17±0.41) or 5FU-alone group (0.92±0.49). Steatohepatitis did not score differ ently among groups, and no difference was seen in postoperative morbidity. No hospital deaths occurred. Conclusions: Oxaliplatin and irinotecan were involved with sinusoidal dilation, but not associated with increased risk for postoperative morbidity or mortality. In CLM patients undergoing preoperative chemotherapy, intensive liver function assessment is therefore important to help ensure safe hepatic resection.

Key words
colorectal liver metastasis, oxaliplatin, irinotecan, sinusoidal dilation, steatohepatitis

Reprint requests
Daisuke Kudou Department of Surgery, Hirosaki University School of Medicine
5 Zaifucho, Hirosaki, 036-8562 JAPAN

Accepted
May 27, 2009

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