caa a22 4500 445338334 CHVBK 20180317142803.0 cr unu---uuuuu 170323e20110201xx s 000 0 eng 10.1245/s10434-010-1317-4 doi (NATIONALLICENCE)springer-10.1245/s10434-010-1317-4 Sinusoidal Obstruction Syndrome Impairs Long-Term Outcome of Colorectal Liver Metastases Treated with Resection after Neoadjuvant Chemotherapy [Elektronische Daten] [Dietmar Tamandl, Markus Klinger, Sandra Eipeldauer, Beata Herberger, Klaus Kaczirek, Birgit Gruenberger, Thomas Gruenberger] Background: Chemotherapy-induced liver injury is a considerable problem in patients undergoing surgery for colorectal liver metastases, since an increase in postoperative morbidity and mortality has been observed. We investigated whether liver damage had further implications on long-term outcome in these patients. Materials and Methods: Liver specimens from 196 patients resected for colorectal liver metastases were evaluated for chemotherapy-associated hepatic damage in the nontumorous liver. Injury patterns were correlated with recurrence free (RFS) and overall survival (OS). Factors leading to sinusoidal injury were identified. Results: Patients who developed grade 2 or 3 sinusoidal dilatation had a significantly shorter RFS (hazard ratio [HR] 2.05; 95% confidence interval [95% CI] 1.23-3.39, P=.005) and OS (HR 2.90; 95% CI 1.61-6.19, P<.001), compared to patients without this alteration. Those patients also had significantly more intrahepatic recurrences (66.7% vs 30.5%, P=.003). Other patterns of chemotherapy-associated liver damage (nonalcoholic steatohepatitis, fibrosis) were not associated with impaired survival. Factors indicating sinusoidal injury were oxaliplatin-based chemotherapy, tumor size >5cm, and elevated alkaline phosphatase or gamma glutamyltransferase. Conclusions: Sinusoidal obstruction syndrome due to oxaliplatin-based chemotherapy may not only compromise perioperative outcome, but can lead to early recurrence and decreased survival in the long term. Strategies to prevent this condition are clearly needed. Society of Surgical Oncology, 2010 Tamandl Dietmar Department of Surgery, Medical University of Vienna, Vienna, Austria aut Klinger Markus Department of Surgery, Medical University of Vienna, Vienna, Austria aut Eipeldauer Sandra Department of Pathology, Medical University of Vienna, Vienna, Austria aut Herberger Beata Department of Surgery, Medical University of Vienna, Vienna, Austria aut Kaczirek Klaus Department of Surgery, Medical University of Vienna, Vienna, Austria aut Gruenberger Birgit Department of Internal Medicine, Division of Oncology, Krankenanstalt Barmherzige Brüder, Vienna, Austria aut Gruenberger Thomas Department of Surgery, Medical University of Vienna, Vienna, Austria aut Annals of Surgical Oncology Springer-Verlag 18/2(2011-02-01), 421-430 1068-9265 18:2<421 2011 18 10434 https://doi.org/10.1245/s10434-010-1317-4 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-010-1317-4 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Tamandl Dietmar Department of Surgery, Medical University of Vienna, Vienna, Austria aut NATIONALLICENCE 700 1- Klinger Markus Department of Surgery, Medical University of Vienna, Vienna, Austria aut NATIONALLICENCE 700 1- Eipeldauer Sandra Department of Pathology, Medical University of Vienna, Vienna, Austria aut NATIONALLICENCE 700 1- Herberger Beata Department of Surgery, Medical University of Vienna, Vienna, Austria aut NATIONALLICENCE 700 1- Kaczirek Klaus Department of Surgery, Medical University of Vienna, Vienna, Austria aut NATIONALLICENCE 700 1- Gruenberger Birgit Department of Internal Medicine, Division of Oncology, Krankenanstalt Barmherzige Brüder, Vienna, Austria aut NATIONALLICENCE 700 1- Gruenberger Thomas Department of Surgery, Medical University of Vienna, Vienna, Austria aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/2(2011-02-01), 421-430 1068-9265 18:2<421 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer