title: Nodular regenerative hyperplasia: a deleterious consequence of chemotherapy for colorectal liver metastases?
abstract: OBJECTIVE
  This report describes three patients suffering from nodular regenerative hyperplasia (NRH).
  
  
  METHODS
  These patients have received six, 16 and 20 cycles of neoadjuvant 5-fluorouracil and oxaliplatin-based chemotherapy before planned extended hepatectomy. Two patients underwent uneventful portal vein embolization to hypertrophy the future remnant liver.
  
  
  RESULTS
  At the end of chemotherapy, liver function tests deteriorated and portal hypertension appeared in two patients, including ascites, splenomegaly and oesophageal varices. Liver biopsy was performed through a percutaneous (two patients) or a transjugular approach (one patient) and allowed the diagnosis of NRH, which was considered to be a contraindication for major liver resection in all three patients, associated with extrahepatic disease progression in one patient. All patients died from neoplastic disease progression despite further chemotherapy at 6, 17 and 31 months following the diagnosis of NRH. One patient developed liver failure and ascites at the time of death.
  
  
  CONCLUSIONS
  Physicians should be aware of the potential occurrence and therapeutic impact of NRH in patients suffering from CRLM and treated by neoadjuvant 5FU-oxaliplatin-based chemotherapy before major liver surgery.
authors: Department of Abdominal Surgery and Transplantation, Division of Hepato-Biliary and Pancreatic Surgery, Saint-Luc University Hospital, Université Catholique de Louvain (UCL), Brussels, Belgium.
authors: Catherine
authors: C
authors: Hubert
authors: Christine
authors: C
authors: Sempoux
authors: Yves
authors: Y
authors: Horsmans
authors: Jacques
authors: J
authors: Rahier
authors: Yves
authors: Y
authors: Humblet
authors: Jean-Pascal
authors: JP
authors: Machiels
authors: Antonino
authors: A
authors: Ceratti
authors: Jean-Luc
authors: JL
authors: Canon
authors: Jean-François
authors: JF
authors: Gigot
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D056486:Chemical and Drug Induced Liver Injury; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D000075202:Contraindications; D018450:Disease Progression; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006498:Hepatectomy; D006801:Humans; D006965:Hyperplasia; D008099:Liver / Q000187:drug effects* / Q000473:pathology / Q000601:surgery; D008107:Liver Diseases / Q000175:diagnosis / Q000401:mortality / Q000473:pathology / Q000628:therapy; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000556:secondary / Q000601:surgery; D008115:Liver Regeneration / Q000187:drug effects*; D008297:Male; D008875:Middle Aged; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D000077150:Oxaliplatin; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D009944:Organoplatinum Compounds; D000077150:Oxaliplatin; D005472:Fluorouracil