caa a22 4500 44533486X CHVBK 20180317142751.0 cr unu---uuuuu 170323e20110301xx s 000 0 eng 10.1245/s10434-010-1385-5 doi (NATIONALLICENCE)springer-10.1245/s10434-010-1385-5 Regenerative Nodular Hyperplasia of the Liver Related to Chemotherapy: Impact on Outcome of Liver Surgery for Colorectal Metastases [Elektronische Daten] [Dennis Wicherts, Robbert de Haas, Mylène Sebagh, Oriana Ciacio, Francis Lévi, Bernard Paule, Sylvie Giacchetti, Catherine Guettier, Daniel Azoulay, Denis Castaing, René Adam] Background: Regenerative nodular hyperplasia (RNH) represents the end-stage of vascular lesions of the liver induced by chemotherapy. The goal was to evaluate its incidence and impact on the outcome of patients resected for colorectal liver metastases (CLM). Methods: Patients who underwent hepatectomy for CLM after six cycles or more of first-line chemotherapy, between January 1990 and November 2006, were included. Detailed histopathologic analysis of the nontumoral liver was performed according to a standard format. Results: From a cohort of 856 resected patients at our institution, 771 (90%) received preoperative chemotherapy. Of these, 146 fulfilled the selection criteria and were included: 24 (16%) received 5-fluorouracil (5-FU) and leucovorin (LV) alone, 92 (63%) had 5-FU/LV and oxaliplatin, 18 (12%) had 5-FU/LV and irinotecan, and 12 (8%) were treated by 5-FU/LV, oxaliplatin, and irinotecan. RNH occurred in 22 of 146 patients (15%). Twenty of these patients (91%) received oxaliplatin, of whom six (30%) had chronomodulated therapy. Patients treated by oxaliplatin more often had RNH compared with oxaliplatin-naïve patients (22 vs. 4%). Although operative mortality was nil, the presence of RNH was associated with increased postoperative hepatic morbidity (50 vs. 29%). Elevated preoperative gamma-glutamyltransferase (GGT) (>80U/L; >1N) and total bilirubin levels (>15μmol/L; >1N) were independent predictors of RNH. Conclusions: Patients with CLM who receive preoperative oxaliplatin have an increased risk of RNH and associated postoperative morbidity. Increased serum GGT and bilirubin are useful markers to predict the presence of RNH. The Author(s), 2010 Wicherts Dennis Centre Hépato-Biliaire, AP-HP Hôpital Paul Brousse, Villejuif, France aut de Haas Robbert Centre Hépato-Biliaire, AP-HP Hôpital Paul Brousse, Villejuif, France aut Sebagh Mylène Department of Pathology, AP-HP Hôpital Paul Brousse, Villejuif, France aut Ciacio Oriana Centre Hépato-Biliaire, AP-HP Hôpital Paul Brousse, Villejuif, France aut Lévi Francis Department of Medical Oncology, AP-HP Hôpital Paul Brousse, Villejuif, France aut Paule Bernard Centre Hépato-Biliaire, AP-HP Hôpital Paul Brousse, Villejuif, France aut Giacchetti Sylvie Department of Medical Oncology, AP-HP Hôpital Paul Brousse, Villejuif, France aut Guettier Catherine Department of Pathology, AP-HP Hôpital Paul Brousse, Villejuif, France aut Azoulay Daniel Centre Hépato-Biliaire, AP-HP Hôpital Paul Brousse, Villejuif, France aut Castaing Denis Centre Hépato-Biliaire, AP-HP Hôpital Paul Brousse, Villejuif, France aut Adam René Centre Hépato-Biliaire, AP-HP Hôpital Paul Brousse, Villejuif, France aut Annals of Surgical Oncology Springer-Verlag 18/3(2011-03-01), 659-669 1068-9265 18:3<659 2011 18 10434 https://doi.org/10.1245/s10434-010-1385-5 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-010-1385-5 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Wicherts Dennis Centre Hépato-Biliaire, AP-HP Hôpital Paul Brousse, Villejuif, France aut NATIONALLICENCE 700 1- de Haas Robbert Centre Hépato-Biliaire, AP-HP Hôpital Paul Brousse, Villejuif, France aut NATIONALLICENCE 700 1- Sebagh Mylène Department of Pathology, AP-HP Hôpital Paul Brousse, Villejuif, France aut NATIONALLICENCE 700 1- Ciacio Oriana Centre Hépato-Biliaire, AP-HP Hôpital Paul Brousse, Villejuif, France aut NATIONALLICENCE 700 1- Lévi Francis Department of Medical Oncology, AP-HP Hôpital Paul Brousse, Villejuif, France aut NATIONALLICENCE 700 1- Paule Bernard Centre Hépato-Biliaire, AP-HP Hôpital Paul Brousse, Villejuif, France aut NATIONALLICENCE 700 1- Giacchetti Sylvie Department of Medical Oncology, AP-HP Hôpital Paul Brousse, Villejuif, France aut NATIONALLICENCE 700 1- Guettier Catherine Department of Pathology, AP-HP Hôpital Paul Brousse, Villejuif, France aut NATIONALLICENCE 700 1- Azoulay Daniel Centre Hépato-Biliaire, AP-HP Hôpital Paul Brousse, Villejuif, France aut NATIONALLICENCE 700 1- Castaing Denis Centre Hépato-Biliaire, AP-HP Hôpital Paul Brousse, Villejuif, France aut NATIONALLICENCE 700 1- Adam René Centre Hépato-Biliaire, AP-HP Hôpital Paul Brousse, Villejuif, France aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/3(2011-03-01), 659-669 1068-9265 18:3<659 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer