Work

Splenic hypertrophy predicts liver-specific complications in patients undergoing major liver resection for colorectal liver metastases, after preoperative chemotherapy

Year: 2024

Type: article

Abstract: Background: In patients with colorectal liver metastases (CRLM), preoperative chemotherapy may increase resectability and survival outcomes. However, cytotoxic agents can also cause chemotherapy-associated liver injury (CALI), leading to increased rates of postoperative complications. This study evaluates the association between splenic hypertrophy (SH) after preoperative chemotherapy and postoperative liver-specific complications (LSC), in patients undergoing major liver resection for CRLM. Methods: This retrospective study included patients who underwent major curative liver resection of CRLM following preoperative chemotherapy at the University Hospital RWTH Aachen (UH-RWTH) between 2010-2021. Patients with missing radiological images, incomplete data on chemotherapy regimens, or prior splenectomy were excluded. Volumetric measurements of the spleen were performed on preoperative computerized tomography (CT) and magnetic resonance imaging (MRI) images, using segmentation software (3D-Slicer). Receiver-operating characteristic (ROC) analysis was performed to determine the optimal SH cut-off for predicting postoperative LSC. Independent risk factors of postoperative LSC were examined using logistic regression. Results: 38%, P=0.007). Multivariable logistic regression analysis identified SH >8.6% as an independent risk factor for LSC (odds ratio 2.86, 95% confidence interval: 1.104-7.402, P=0.03). Conclusions: Preoperative SH may be a valuable predictor of postoperative LSC in patients undergoing major liver resection for CRLM, following chemotherapy. Further studies are necessary to investigate the impact on a larger cohort and find preventive strategies to mitigate and treat CALI.

Source: HepatoBiliary Surgery and Nutrition

DOI: 10.21037/hbsn-24-121