A splenic volume increase due to preoperative chemotherapy may impair the long-term outcome after hepatectomy in patients with initially non-optimally resectable colorectal cancer liver metastases.
OBJECTIVE
In patients with colorectal cancer liver metastases (CRCLM), chemotherapy-associated hepatotoxicity (CAH) has been shown to be associated with splenomegaly. The aim of the present study was to investigate whether a higher splenic volume increase (SVI) after preoperative chemotherapy was associated with a worse long-term outcome after hepatectomy in patients with CRCLM.


METHODS
Between 2007 and 2012, there were 36 patients who received preoperative chemotherapy based on a diagnosis of initially non-optimally resectable synchronous CRCLM. The splenic volume was measured by CT-volumetry before preoperative chemotherapy and 12 weeks after the start of the chemotherapy. Long-term outcome was analyzed in these patients.


RESULTS
The overall survival was significantly shorter in the SVI ≥30% group than in the SVI <30% group (3-year survival = 52% vs. 28%, p <0.05). The disease-free survival was also significantly shorter in the SVI ≥30% group than in the SVI <30% group (Median = 11 vs. 6 months, p <0.05). The survival after recurrence was significantly shorter in the SVI ≥30% group than in the SVI <30% group (Median = 12.0 vs. 18 months, p<0.05).


CONCLUSIONS
In patients with non-optimally resectable CRCLM, the SVI during the first 12 weeks of preoperative chemotherapy may be a significant predictor of the long-term survival after hepatectomy.
Masafumi
M
Katayama
Hiroshi
H
Nakano
Shinya
S
Kishi
Shinjiro
S
Kobayashi
Satoshi
S
Koizumi
Tetsu
T
Fukunaga
Nobuyoshi
N
Miyajima
Takehito
T
Otsubo
D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects*; D015179:Colorectal Neoplasms / Q000473:pathology*; D005260:Female; D006498:Hepatectomy / Q000401:mortality; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D013154:Spleen / Q000187:drug effects* / Q000473:pathology; D016896:Treatment Outcome
D000970:Antineoplastic Agents