title: Adjuvant FOLFOX chemotherapy and splenomegaly in patients with stages II-III colorectal cancer.
abstract: BACKGROUND
  The impact of adjuvant chemotherapy on hepatic function and portal hypertension in patients with stages II-III colon cancer has not been previously described. We conducted a retrospective study to assess the effects of adjuvant FOLFOX chemotherapy on the splenic index (SI) as a surrogate marker for portal hypertension.
  
  
  METHODS
  Stage II-III colorectal cancer patients treated with adjuvant FOLFOX or fluorouracil/leucovorin (5-FU/LV) at Roswell Park Cancer Institute between 2002 and 2006 were identified. Computerizedt omography (CT) scans obtained prior to and at completion of chemotherapy, and every 6 months thereafter were reviewed. Splenic size was evaluated using the SI (SI = length x width x height of the spleen).
  
  
  RESULTS
  40 patients were identified in the FOLFOX group and 23 in the 5-FU/LV group. After 6 months of adjuvant chemotherapy, the mean increase in SI was 45.7 and 16.3% in the FOLFOX and 5-FU/LV groups, respectively (p = 0.0069). SI increased by >100% in 6 patients (15%) in the FOLFOX group versus none in the 5-FU/LV group (p = 0.16). The mean SI at completion of adjuvant chemotherapy was significantly higher in the FOLFOX group than in the 5-FU/LV group (p = 0.007). The mean SI decreased steadily over a period of 2 years after discontinuation of FOLFOX, suggesting potential reversibility of oxaliplatin-induced hepatic injury in this setting.
  
  
  CONCLUSIONS
  Adjuvant FOLFOX significantly increases the SI in patients with resected colorectal cancer in comparison to adjuvant 5-FU/LV. The increase in SI may be a marker of oxaliplatin-induced hepatic injury and should be investigated further in prospective longitudinal studies of oxaliplatin-based adjuvant chemotherapy.
authors.affiliation: Arlington Cancer Center, Arlington, TX, USA.
authors.forename: Revathi
authors.initials: R
authors.lastname: Angitapalli
authors.forename: Alan M
authors.initials: AM
authors.lastname: Litwin
authors.forename: Prasanna R G
authors.initials: PR
authors.lastname: Kumar
authors.forename: Eiad
authors.initials: E
authors.lastname: Nasser
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Lombardo
authors.forename: Terry
authors.initials: T
authors.lastname: Mashtare
authors.forename: Gregory E
authors.initials: GE
authors.lastname: Wilding
authors.forename: Marwan G
authors.initials: MG
authors.lastname: Fakih