RxPG News Feed for RxPG News

Medical Research Health Special Topics World
 Asian Health
 Food & Nutrition
 Men's Health
 Mental Health
 Occupational Health
 Public Health
 Sleep Hygiene
 Women's Health
 Canada Healthcare
 China Healthcare
 India Healthcare
 New Zealand
 South Africa
 World Healthcare
   Latest Research
 Alternative Medicine
  Bone Cancer
  Breast Cancer
  Cervical Cancer
  Gastric Cancer
  Liver Cancer
  Nerve Tissue
  Ovarian Cancer
  Pancreatic Cancer
  Prostate Cancer
  Rectal Cancer
  Renal Cell Carcinoma
  Risk Factors
  Testicular Cancer
 Clinical Trials
 Infectious Diseases
 Sports Medicine
   Medical News
 Awards & Prizes
   Special Topics
 Odd Medical News

Last Updated: Oct 11, 2012 - 10:22:56 PM
Liver Cancer Channel

subscribe to Liver Cancer newsletter
Latest Research : Cancer : Liver Cancer

   EMAIL   |   PRINT
Pre-screening before chemotherapy recommended to avoid worst liver damage

May 1, 2006 - 12:30:00 AM , Reviewed by: Priya Saxena
"Most patients who use preoperative chemotherapy when their colorectal cancer spreads to the liver do just fine. But this study shows us that we need to screen patients in advance and use the drug that is right for them."

[RxPG] Patients and their physicians should be careful when selecting a chemotherapy drug to treat colorectal cancer that has spread to the liver, say researchers at The University of Texas M. D. Anderson Cancer Center in Houston.

While surgery to remove liver metastases also has proven beneficial, both of the most commonly used chemotherapy drugs to treat these tumors can seriously injure the liver the researchers report in the May 1 issue of the Journal of Clinical Oncology. Furthermore the damage caused to the liver by these preoperative chemotherapy regimens can adversely affects long-term surgical outcomes.

Use of chemotherapy before surgery offers several important benefits, including reducing the size of tumors such that they are more easily removed and, potentially doubling the survival rate.

Results of their 13-year study of 406 patients, treated either at M. D. Anderson or at a hospital in Torino, Italy, found that one drug, irinotecan, produced steatohepatitis (an inflamed "fatty" liver) in 20 percent of patients who used it, and three of those patients later died.

Most of these complications were seen in patients who were overweight or who already had a fatty liver, a condition known as steatosis, says lead author Jean-Nicolas Vauthey, M.D., professor in the Department of Surgical Oncology at M. D. Anderson.

"Most patients who use preoperative chemotherapy when their colorectal cancer spreads to the liver do just fine," Vauthey says. "But this study shows us that we need to screen patients in advance and use the drug that is right for them."

The other most commonly used chemotherapy drug, oxaliplatin, produced sinusoidal dilation (swelling and leaking of blood vessels in the liver) in almost 19 percent of patients who used it, but no deaths were associated with this condition.

"Although such serious complications are comparatively rare, our finding that the choice of chemotherapy matters in outcome will become increasingly important as this surgery becomes more widespread," Vauthey says.

According to the American Cancer Society, more than 146,000 Americans will be diagnosed with cancers of the colon and rectum in 2006. Liver metastasis usually develops from colorectal cancer, and the number of surgeries now performed to remove these tumors is about 10,000 a year "and is expected to double in the near future," Vauthey says.

The study is the first to analyze the association between chemotherapy use before surgery, changes in the function of the liver and postoperative outcome in patients with liver metastases. It is also the first to monitor patient progress for 90 days post surgery. Most surgery outcome studies follow patients for only 30 days, "which is not long enough for these complications to develop," Vauthey says.

Of the 406 patients enrolled in the study, 248 were treated with preoperative chemotherapy and 158 were not. For the entire group, the perioperative complication rate was about 21 percent, and injury to the liver occurred in almost 23 percent. Steatosis was identified in almost nine percent as was high-grade sinusoidal dilation, and steatohepatitis occurred in about eight percent of patients. The investigators further found that while no specific chemotherapy regimen was linked to development of steatosis, oxaliplatin was associated with sinusoidal injury and irinotecan was connected to steatohepatitis when compared to patients who did not receive chemotherapy.

In all, 11 patients died within 90 days of surgery, and six of those deaths occurred in the 92 patients who had hepatic injuries. Five of those patients had steatohepatitis, and one had steatosis. Of the five patients who developed steatohepatitis, three had been treated with irinotecan.

Although steatohepatitis is typically a benign condition, "its presence in patients undergoing chemotherapy treatment may result in failure to regenerate new liver tissue, which can lead to liver disease and failure," Vauthey says.

Researchers further noted that irinotecan was associated with an increased risk of steatohepatitis whether or not a patient was overweight, but that the effect was more pronounced in patients with a higher body mass index (BMI).

Given these findings, researchers recommend patients be screened for BMI and for preexisting steatosis, which chemotherapy can morph into steatohepatitis. Patients in these categories should avoid irinotecan, Vauthey says. "Most patients who use preoperative chemotherapy when their colorectal cancer spreads to the liver do just fine," he says.

While both oxaliplatin and irinotecan are equally effective when combined with fluorouracil, as are other chemotherapy regimens, "this study shows us that we need to screen patients in advance and use the drug that is right for them, Vauthey says "

Publication: May 1 issue of the Journal of Clinical Oncology
On the web: www.mdanderson.org 

Advertise in this space for $10 per month. Contact us today.

Related Liver Cancer News
Thalidomide may help as adjuvant therapy for hepatocellular carcinoma
Chlorophyll limits the absorption of the carcinogen aflatoxin
Sunitinib slows tumor growth and metastasis in hepatocellular carcinoma
Combined stenting and photodynamic therapy may improve survival rates in liver cancer
Percutaneous radiofrequency ablation of liver tumors prove safe and effective
Cancer cells metastatic to the liver are a perfect target for gene therapy, study reports
Nexavar shown to significantly extend survival for patients with advanced liver cancer
Colchicine can delay the development of hepatocellular carcinoma
Study implicates two human genes in liver cancer
Skin rash after lapatinib for liver cancer determines survival

Subscribe to Liver Cancer Newsletter

Enter your email address:

 Additional information about the news article
Co-authors include Tsung-Teh Wu, M.D., Ph.D.; Henry Xiong, M.D.; Cathy Eng, M.D.; Steven Curley, M.D. and Eddie Abdalla, M.D. of M. D. Anderson, Timothy Pawlik; Dario Ribero; Daria Zorzi; Paulo Hoff; Gregory Lauwers; Mari Mino-Kenudson; Mauro Risio; Andrea Muratore; Lorenzo Capussotti;
For any corrections of factual information, to contact the editors or to send any medical news or health news press releases, use feedback form

Top of Page

Contact us

RxPG Online



    Full Text RSS

© All rights reserved by RxPG Medical Solutions Private Limited (India)