title: [Chemotherapy-associated steatohepatitis in patients with colorectal cancer and surgery on hepatic metastasis: clinical validation of a histopathological scoring system and preoperative risk assessment].
abstract: Colorectal cancer (CRC) can only be cured by complete resection of the tumour. Primarily unresectable metastases of the liver are treated by chemotherapy to achieve down-sizing of metastasis and curative resection. Chemotherapy can affect tumour-free healthy liver tissue and lead to histopathological and functional changes summarised as "chemotherapy-associated steatohepatitis" (CASH). We have evaluated a histopathological scoring system for CASH and searched for preoperative risk factors for the development of CASH. Liver alterations such as CASH were more pronounced when patients received chemotherapy, especially when treated with oxaliplatin. A higher BMI, male sex and elevated serum transaminases were risk factors for the development of CASH. Patients with a higher CASH score, reflecting more advanced changes in liver tissue, had a higher serum peak bilirubin level postoperatively. We did not find a higher morbidity or mortality in patients with a more severe liver damage measured by the CASH score.
authors.affiliation: Medizinische Universitätsklinik, Knappschaftskrankenhaus, Ruhr-Universität Bochum. tobkamp@googlemail.com
authors.forename: T
authors.initials: T
authors.lastname: Kampfenkel
authors.forename: I
authors.initials: I
authors.lastname: Tischoff
authors.forename: H
authors.initials: H
authors.lastname: Bonhag
authors.forename: M
authors.initials: M
authors.lastname: Eckardt
authors.forename: W
authors.initials: W
authors.lastname: Schmiegel
authors.forename: A
authors.initials: A
authors.lastname: Tannapfel
authors.forename: A
authors.initials: A
authors.lastname: Reinacher-Schick
authors.forename: R
authors.initials: R
authors.lastname: Viebahn
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000627:therapeutic use; D015992:Body Mass Index; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D003131:Combined Modality Therapy; D005234:Fatty Liver / Q000139:chemically induced* / Q000473:pathology; D005260:Female; D006801:Humans; D008099:Liver / Q000187:drug effects / Q000473:pathology / Q000601:surgery; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000556:secondary* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009944:Organoplatinum Compounds / Q000008:administration & dosage / Q000009:adverse effects; D000077150:Oxaliplatin; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D016019:Survival Analysis
chemical_list: D009944:Organoplatinum Compounds; D000077150:Oxaliplatin