title: Splenic volume may be a useful indicator of the protective effect of bevacizumab against oxaliplatin-induced hepatic sinusoidal obstruction syndrome.
abstract: OBJECTIVE
  The aim of this study was to investigate the relationship between the use of bevacizumab (Bmab) in addition to oxaliplatin (OX), the development of sinusoidal obstruction syndrome (SOS) and the changes in splenic volume as an indicator of the protective effect of Bmab against OX-induced SOS.
  
  
  METHODS
  Seventy-nine patients who received OX-based chemotherapy with (OX + Bmab group: n = 48) or without Bmab (OX group: n = 31) for colorectal liver metastases were included in this study. The changes in splenic volume after chemotherapy were evaluated in the two groups. Furthermore, the relationship between the changes in splenic volume and SOS were analyzed in the 55 patients who underwent hepatectomy.
  
  
  RESULTS
  A significant increase in the splenic volume was observed in the OX group, but not in the OX + Bmab group. The increase in the splenic volume relative to baseline was significantly higher in the OX group than in the OX + Bmab group (39.1% vs. 2.3%, p < 0.0001). The incidence of moderate or severe SOS was significantly higher in the OX group than in the OX + Bmab group (50.0% vs. 16.0%, p = 0.0068), and the increase in the splenic volume was significantly higher in the patients with SOS than in those without SOS (42.9% vs. 9.9%, p = 0.0001). A multivariate analysis identified the increase in the splenic volume as an independent predictor of the development of SOS.
  
  
  CONCLUSIONS
  This study demonstrated that the inhibition of splenic volume enlargement might be a useful indicator of the protective effect of Bmab against OX-induced SOS.
authors.affiliation: Department of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Imai
authors.affiliation: Department of Surgery and Science, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Emi
authors.affiliation: Department of Surgical Pathology, Kumamoto University Hospital, Kumamoto, Japan.
authors.forename: K-I
authors.initials: KI
authors.lastname: Iyama
authors.affiliation: Department of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Beppu
authors.affiliation: Department of Surgery, Kurume University Medical Center, Kurume, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Ogata
authors.affiliation: Department of Surgery, Division of Gastrointestinal Surgery, Graduate School of Medicine, Kobe University, Kobe, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Kakeji
authors.affiliation: Division of Digestive and General Surgery, Faculty of Medicine, University of the Ryukyus, Okinawa, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Samura
authors.affiliation: Department of Surgery and Science, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan.
authors.forename: E
authors.initials: E
authors.lastname: Oki
authors.affiliation: Department of Surgery, Kurume University Hospital, Kurume, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Akagi
authors.affiliation: Department of Surgery and Science, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Maehara
authors.affiliation: Department of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto, Japan. Electronic address: hdobaba@kumamoto-u.ac.jp.
authors.forename: H
authors.initials: H
authors.lastname: Baba
mesh_terms: D000368:Aged; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000009:adverse effects*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D000068258:Bevacizumab; D015179:Colorectal Neoplasms / Q000473:pathology*; D005260:Female; D005472:Fluorouracil / Q000627:therapeutic use; D006504:Hepatic Veno-Occlusive Disease / Q000139:chemically induced / Q000517:prevention & control*; D006801:Humans; D002955:Leucovorin / Q000627:therapeutic use; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000556:secondary; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D009944:Organoplatinum Compounds / Q000009:adverse effects* / Q000627:therapeutic use; D000077150:Oxaliplatin; D011859:Radiography; D012189:Retrospective Studies; D013154:Spleen / Q000000981:diagnostic imaging*; D016896:Treatment Outcome
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D009944:Organoplatinum Compounds; D000077150:Oxaliplatin; D000068258:Bevacizumab; D002955:Leucovorin; D005472:Fluorouracil
keywords: Bevacizumab; Colorectal liver metastases; Oxaliplatin; Sinusoidal obstruction syndrome; Splenic volume