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Nodular regenerative hyperplasia : a deleterious consequence of chemotherapy for colorectal liver metastases?

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Hubert, Catherine [UCL] Sempoux, Christine [UCL] Horsmans, Yves [UCL] Rahier, Jacques [UCL] Humblet, Yves [UCL] Machiels, Jean-Pascal [UCL] Ceratti, Antonino [UCL] Gigot, Jean-François [UCL]

AIMS: This report describes three patients suffering from nodular regenerative hyperplasia (NRH). METHODS: These patients have received six, 16 and 20 cycles of neoadjuvant 5-fluorouracil and oxaliplatin-based chemotherapy before planned extended hepatectomy. Two patients underwent uneventful portal vein embolization to hypertrophy the future remnant liver. RESULTS: At the end of chemotherapy, liver function tests deteriorated and portal hypertension appeared in two patients, including ascites, splenomegaly and oesophageal varices. Liver biopsy was performed through a percutaneous (two patients) or a transjugular approach (one patient) and allowed the diagnosis of NRH, which was considered to be a contraindication for major liver resection in all three patients, associated with extrahepatic disease progression in one patient. All patients died from neoplastic disease progression despite further chemotherapy at 6, 17 and 31 months following the diagnosis of NRH. One patient developed liver failure and ascites at the time of death. CONCLUSIONS: Physicians should be aware of the potential occurrence and therapeutic impact of NRH in patients suffering from CRLM and treated by neoadjuvant 5FU-oxaliplatin-based chemotherapy before major liver surgery.

Document type Article de périodique (Journal article) – Article de recherche – Journal Article
Access type Accès restreint
Publication date 2007
Language Anglais
Journal information "Liver International" - Vol. 27, no. 7, p. 938-943 (2007)
Peer reviewed yes
Publisher Wiley-Blackwell Munksgaard ((Denmark) Copenhagen V)
issn 1478-3223
e-issn 1478-3231
Publication status Publié
Affiliations UCL - MD/MNOP - Département de morphologie normale et pathologique
UCL - MD/MINT - Département de médecine interne
UCL - MD/CHIR - Département de chirurgie
UCL - (SLuc) Service de chirurgie et transplantation abdominale
UCL - (SLuc) Service d'anatomie pathologique
UCL - (SLuc) Unité d'oncologie médicale
UCL - (SLuc) Service d'hépato-gastro-entérologie
MESH Subject Aged ; Antineoplastic Combined Chemotherapy Protocols - adverse effects ; Chemotherapy, Adjuvant - adverse effects ; Colorectal Neoplasms - drug therapy - mortality - pathology - surgery ; Disease Progression ; Female ; Fluorouracil - administration & dosage ; Hepatectomy - contraindications ; Humans ; Hyperplasia ; Liver - drug effects - pathology - surgery ; Liver Diseases - chemically induced - diagnosis - mortality - pathology - therapy ; Liver Function Tests ; Liver Neoplasms - drug therapy - mortality - secondary - surgery ; Liver Regeneration - drug effects ; Male ; Middle Aged ; Organoplatinum Compounds - administration & dosage ; Time Factors ; Treatment Outcome
Links
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Bibliographic reference Hubert, Catherine ; Sempoux, Christine ; Horsmans, Yves ; Rahier, Jacques ; Humblet, Yves ; et. al. Nodular regenerative hyperplasia : a deleterious consequence of chemotherapy for colorectal liver metastases?. In: Liver International, Vol. 27, no. 7, p. 938-943 (2007)
Permanent URL http://hdl.handle.net/2078.1/11070