title: Sinusoidal obstruction syndrome (SOS) related to chemotherapy for colorectal liver metastases: factors predictive of severe SOS lesions and protective effect of bevacizumab.
abstract: OBJECTIVE
  The most frequent presentation of chemotherapy-related toxicity in colorectal liver metastases (CRLM) is sinusoidal obstruction syndrome (SOS). The purpose of the present study was to identify preoperative factors predictive of SOS and to establish associations between type of chemotherapy and severity of SOS.
  
  
  METHODS
  A retrospective study was carried out in a tertiary academic referral hospital. Patients suffering from CRLM who had undergone resection of at least one liver segment were included. Grading of SOS on the non-tumoral liver parenchyma was accomplished according to the Rubbia-Brandt criteria. A total of 151 patients were enrolled and divided into four groups according to the severity of SOS (grades 0-3).
  
  
  RESULTS
  Multivariate analysis identified oxaliplatin and 5-fluorouracil as chemotherapeutic agents responsible for severe SOS lesions (P < 0.001 and P = 0.005, respectively). Bevacizumab was identified as having a protective effect against the occurrence of SOS lesions (P = 0.005). Univariate analysis identified the score on the aspartate aminotransferase : platelets ratio index (APRI) as the most significant biological factor predictive of severe SOS lesions. Splenomegaly is also significantly associated with the occurrence of severe SOS lesions.
  
  
  CONCLUSIONS
  The APRI score and splenomegaly are effective as factors predictive of SOS. Bevacizumab has a protective effect against SOS.
authors: Division of Hepatobiliary and Pancreatic Surgery, Department of Abdominal Surgery and Transplantation, Saint-Luc University Hospital, Université Catholique de Louvain, Brussels, Belgium.
authors: Catherine
authors: C
authors: Hubert
authors: Department of Pathology, Saint-Luc University Hospital, Université Catholique de Louvain, Brussels, Belgium.
authors: Christine
authors: C
authors: Sempoux
authors: Department of Medical Oncology, Saint-Luc University Hospital, Université Catholique de Louvain, Brussels, Belgium.
authors: Yves
authors: Y
authors: Humblet
authors: Department of Medical Oncology, Saint-Luc University Hospital, Université Catholique de Louvain, Brussels, Belgium.
authors: Marc
authors: M
authors: van den Eynde
authors: Department of Internal Medicine, Saint-Luc University Hospital, Université Catholique de Louvain, Brussels, Belgium.
authors: Francis
authors: F
authors: Zech
authors: Laboratory of Hepatogastroenterology, Institut de Recherche Expérimentale et Clinique, Saint-Luc University Hospital, Université Catholique de Louvain, Brussels, Belgium.
authors: Isabelle
authors: I
authors: Leclercq
authors: Division of Hepatobiliary and Pancreatic Surgery, Department of Abdominal Surgery and Transplantation, Saint-Luc University Hospital, Université Catholique de Louvain, Brussels, Belgium.
authors: Jean-François
authors: JF
authors: Gigot
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001219:Aspartate Aminotransferases / Q000097:blood*; D000068258:Bevacizumab / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000097:blood; D015179:Colorectal Neoplasms / Q000097:blood / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006504:Hepatic Veno-Occlusive Disease / Q000139:chemically induced* / Q000175:diagnosis / Q000517:prevention & control; D006801:Humans; D008113:Liver Neoplasms / Q000097:blood / Q000188:drug therapy / Q000556:secondary*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013163:Splenomegaly / Q000150:complications* / Q000175:diagnosis; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D020533:Angiogenesis Inhibitors; D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor; D000068258:Bevacizumab; D001219:Aspartate Aminotransferases