title: Colorectal cancer patients with liver metastases and severe hyperbilirubinemia: A consecutive series that explores the benefits and risks of chemotherapy.
abstract: BACKGROUND
  Do colorectal cancer patients with hyperbilirubinemia and liver metastases benefit from chemotherapy?
  
  
  RESULTS
  This study entailed a review of 3,019 consecutive patients with colorectal cancer. Within this cohort, 20 met the study's a priori selection criteria, which included a new diagnosis of colorectal cancer, no prior therapy, and a total bilirubin of ≥3.0 mg/dL. All 20 patients had liver metastases, and as a whole the group had a median serum bilirubin of 6.4 mg/dL (range 3.1, 28 mg/dL). Six patients received chemotherapy with an oxaliplatin-containing regimen, and four subsequently sustained a drop in their bilirubin. In one instance, a drop from 27.2 to 2.5 mg/dL occurred. These six patients lived a median of 71 days (range 23+, 283 days), but one treatment-related death occurred. In contrast, patients who received only supportive care lived a median of 28 days.
  
  
  CONCLUSIONS
  Chemotherapy appears to provide modest benefit to newly diagnosed colorectal cancer patients with severe hyperbilirubinemia.
authors.affiliation: Division of Medical Oncology, Rochester, MN, USA.
authors.forename: Tamana
authors.initials: T
authors.lastname: Walia
authors.forename: J Fernando
authors.initials: JF
authors.lastname: Quevedo
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Hobday
authors.forename: Gary
authors.initials: G
authors.lastname: Croghan
authors.forename: Aminah
authors.initials: A
authors.lastname: Jatoi