title: Hepatic histopathology and postoperative outcome after preoperative chemotherapy for Chinese patients with colorectal liver metastases.
abstract: OBJECTIVE
  To assess the effects of preoperative treatment on the hepatic histology of non-tumoral liver and the postoperative outcome.
  
  
  METHODS
  One hundred and six patients underwent hepatic resection for colorectal metastases between 1999 and 2009. The surgical specimens were reviewed with established criteria for diagnosis and grading of pathological hepatic injury. The impact of preoperative therapy on liver injury and postoperative outcome was analyzed.
  
  
  RESULTS
  Fifty-three patients (50%) received surgery alone, whereas 42 patients (39.6%) received neoadjuvant chemotherapy and 11 (10.4%) patients received preoperative hepatic artery infusion (HAI). Chemotherapy included oxaliplatin-based regimens (31.1%) and irinotecan-based regimens (8.5%). On histopathological analysis, 16 patients (15.1%) had steatosis, 31 (29.2%) had sinusoidal dilation and 20 patients (18.9%) had steatohepatitis. Preoperative oxaliplatin was associated with sinusoidal dilation compared with surgery alone (42.4% vs 20.8%, P = 0.03); however, the perioperative complication rate was not significantly different between the oxaliplatin group and surgery group (27.3% vs 13.2%, P = 0.1). HAI was associated with more steatosis, sinusoidal dilation and steatohepatitis than the surgery group, with higher perioperative morbidity (36.4% vs 13.2%, P = 0.06) and mortality (9.1% vs 0% P = 0.02).
  
  
  CONCLUSIONS
  Preoperative oxaliplatin was associated with sinusoidal dilation compared with surgery alone. However, the preoperative oxaliplatin had no significant impact on perioperative outcomes. HAI can cause pathological changes and tends to increase perioperative morbidity and mortality.
authors.affiliation: Qi-Ying Lu, Wei Deng, Lin Shen, Department of Gastrointestinal Oncology, Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education, Peking University Cancer Hospital and Institute, Beijing 100142, China.
authors.forename: Qi-Ying
authors.initials: QY
authors.lastname: Lu
authors.forename: Ai-Lian
authors.initials: AL
authors.lastname: Zhao
authors.forename: Wei
authors.initials: W
authors.lastname: Deng
authors.forename: Zhong-Wu
authors.initials: ZW
authors.lastname: Li
authors.forename: Lin
authors.initials: L
authors.lastname: Shen
keywords: Drug liver injury; Hepatic artery infusion; Preoperative chemotherapy; Sinusoidal dilation
references.citation: Ai Zheng. 2009 Jan;28(1):54-6
references.pmid: 19448417
references.citation: Ann Oncol. 2004 Mar;15(3):460-6
references.pmid: 14998849
references.citation: Lancet. 2008 Mar 22;371(9617):963-5
references.pmid: 18358910
references.citation: Ann Surg Oncol. 2008 Jun;15(6):1661-9
references.pmid: 18373123
references.citation: J Gastrointest Surg. 2003 Dec;7(8):1034-44
references.pmid: 14675713
references.citation: J Gastrointest Surg. 2006 Jan;10(1):86-94
references.pmid: 16368496
references.citation: Ann Surg. 2006 Jan;243(1):1-7
references.pmid: 16371728
references.citation: Ai Zheng. 2009 Apr;28(4):441-4
references.pmid: 19622309
references.citation: Neoplasma. 2002;49(1):43-8
references.pmid: 12044059
references.citation: Hepatogastroenterology. 2003 Nov-Dec;50(54):1919-26
references.pmid: 14696433
references.citation: Lancet. 2008 Mar 22;371(9617):1007-16
references.pmid: 18358928
references.citation: Hepatology. 2005 Jun;41(6):1313-21
references.pmid: 15915461
references.citation: Lancet. 1994 Jun 4;343(8910):1405-10
references.pmid: 7515134
references.citation: Cancer Treat Rev. 2004 Aug;30(5):425-36
references.pmid: 15245775
references.citation: J Am Coll Surg. 2005 Jun;200(6):845-53
references.pmid: 15922194
references.citation: J Clin Oncol. 2005 Mar 20;23(9):2038-48
references.pmid: 15774795
references.citation: Br J Surg. 1993 Mar;80(3):274-6
references.pmid: 8472130
references.citation: J Gastrointest Surg. 2007 Jul;11(7):860-8
references.pmid: 17492335
references.citation: Ann Surg. 1999 Sep;230(3):309-18; discussion 318-21
references.pmid: 10493478
references.citation: HPB (Oxford). 2002;4(2):99; author reply 99-100
references.pmid: 18332933
references.citation: Int J Colorectal Dis. 2009 Aug;24(8):943-9
references.pmid: 19424708
references.citation: CA Cancer J Clin. 2005 Jan-Feb;55(1):10-30
references.pmid: 15661684
references.citation: Ann Surg. 2008 Jan;247(1):118-24
references.pmid: 18156931
references.citation: Ann Surg Oncol. 2001 May;8(4):347-53
references.pmid: 11352309
references.citation: Am J Surg Pathol. 2010 Jun;34(6):784-91
references.pmid: 20421779
references.citation: CA Cancer J Clin. 2006 Mar-Apr;56(2):106-30
references.pmid: 16514137
references.citation: Radiologe. 2005 Jul;45(7):633-43
references.pmid: 15316615
references.citation: J Surg Oncol. 2007 Jan 1;95(1):22-7
references.pmid: 17066435
references.citation: J Clin Oncol. 2006 May 1;24(13):2065-72
references.pmid: 16648507