Sinusoidal obstruction syndrome and nodular regenerative hyperplasia are frequent oxaliplatin-associated liver lesions and partially prevented by bevacizumab in patients with hepatic colorectal metastasis
Access StatusFull text of the requested work is not available in DASH at this time ("restricted access"). For more information on restricted deposits, see our FAQ.
Majno, Pietro E
X Zhu, Andrew
Abdalla, Eddie K
Terris, BenoitNote: Order does not necessarily reflect citation order of authors.
MetadataShow full item record
CitationRubbia-Brandt, Laura, Gregory Y Lauwers, Huamin Wang, Pietro E Majno, Kenneth Tanabe, Andrew X Zhu, Catherine Brezault, et al. 2010. “Sinusoidal Obstruction Syndrome and Nodular Regenerative Hyperplasia Are Frequent Oxaliplatin-Associated Liver Lesions and Partially Prevented by Bevacizumab in Patients with Hepatic Colorectal Metastasis.” Histopathology 56 (4) (March): 430–439. doi:10.1111/j.1365-2559.2010.03511.x.
AbstractAIMS: Because of its efficacy, oxaliplatin (OX) is increasingly used as a chemotherapeutic agent in the treatment of colorectal liver metastases (CRLM). Oxaliplatin-associated liver toxicity has been reported and can affect clinical practice, but studies on its prevalence and a full pathological description are lacking. The aims of this study were to fill this gap by providing, from a pathologist's perspective, a detailed assessment of the spectrum of hepatic lesions associated with OX, to suggest a scoring system to quantify them, and to investigate the protective effect of bevacizumab against OX-associated damage. METHODS AND RESULTS: The spectrum of oxaliplatin-associated liver lesions was investigated in a multi-institutional series of surgically resected CRLM (n = 385). Among 274 patients treated by OX, 54% had moderate/severe sinusoidal obstruction syndrome (SOS). Peliosis, centrilobular perisinusoidal/venular fibrosis and nodular regenerative hyperplasia (NRH) developed in 10.6%, 47% and 24.5%, respectively. The 111 patients treated by surgery alone had no lesions. Hepatic lesions were less severe in patients treated with OX/bevacizumab (n = 70) compared with the group treated by OX alone (n = 204), with an incidence of moderate/severe SOS (31.4% versus 62.2%), peliosis (4.3% versus 14.6%), NRH (11.4% versus 28.9%, respectively) and centrilobular/venular fibrosis (31.4% versus 52%, respectively) (P < 0.001). CONCLUSIONS: Pathologists should be aware of the distinctive lesions associated with OX and of their high prevalence. OX-related lesions are less frequent in patients treated with bevacizumab, suggesting that this drug has a preventive effect. Uniform criteria for diagnosis and grading of OX-associated lesions should help to include histological data in the optimal multidisciplinary management of CRLM.
Citable link to this pagehttp://nrs.harvard.edu/urn-3:HUL.InstRepos:35140974
- HMS Scholarly Articles