Histological and immediate postoperative outcome after preoperative cetuximab: case-matched control study.
BACKGROUND
The aim of this study was to analyze the effects of preoperative cetuximab (cetu) on nontumorous liver parenchyma and the clinical and biological outcomes after liver resection for colorectal liver metastases (CLM).


METHODS
Between January 2005 and June 2009, 26 patients who received preoperative cetu were matched to a control group of 26 patients who did not receive cetu. They were matched on the basis of age, gender, body mass index, extent of hepatectomy, and type and number of cycles of neoadjuvant chemotherapy.


RESULTS
Liver function tests, postoperative outcome, and histopathology of the resected liver were compared. There was no mortality. Postoperative morbidity and perioperative bleeding rates were similar in both groups. Serum aspartate aminotransferase and serum alanine aminotransferase were higher on postoperative day 5 in the control group (p = 0.02 and p = 0.04, respectively). In the cetu group, the postoperative peaks of γ-glutamyl transpeptidase and alkaline phosphatase were statistically higher than in the control group. Interestingly, pathological review of the nontumorous liver parenchyma revealed no significant difference between patients who received cetu and those treated without cetu with respect to prevalence of steatosis, steatohepatitis, sinusoidal obstructive syndrome, and fibrosis.


CONCLUSIONS
The addition of cetu to the neoadjuvant chemotherapy regimens does not appear to increase the morbidity rate after hepatectomy for CLM, and also in cases of major hepatectomy. The pathological examination did not show additional injury to the nontumorous liver parenchyma.
Pessaux
Patrick
P
Pôle des Pathologies Digestives, Hépatiques et de la Transplantation, Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg-Université de Strasbourg, Avenue Molière, 67200, Strasbourg, France. patrick.pessaux@chru-strasbourg.fr
Marzano
Ettore
E
Casnedi
Selenia
S
Bachellier
Philippe
P
Jaeck
Daniel
D
Chenard
Marie-Pierre
MP
D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000494:pharmacology; D019072:Antibiotic Prophylaxis; D000911:Antibodies, Monoclonal / Q000008:administration & dosage* / Q000494:pharmacology; D061067:Antibodies, Monoclonal, Humanized; D016022:Case-Control Studies; D000068818:Cetuximab; D015179:Colorectal Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008099:Liver / Q000187:drug effects* / Q000378:metabolism / Q000473:pathology; D008113:Liver Neoplasms / Q000556:secondary / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000068818:Cetuximab