Chemotherapy hepatotoxicity : histologic injury and impact on motbility after hepatectomy for colorectal cancer liver metastases

Detalhes bibliográficos
Autor(a) principal: Martins, João Miguel Alves
Data de Publicação: 2015
Tipo de documento: Dissertação
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: http://hdl.handle.net/10316/30731
Resumo: Trabalho final de mestrado integrado em Medicina (Cirurgia Geral), apresentado á Faculdade de Medicina da Universidade de Coimbra
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spelling Chemotherapy hepatotoxicity : histologic injury and impact on motbility after hepatectomy for colorectal cancer liver metastasesNeoplasias colorrectaisQuimioterapiaTrabalho final de mestrado integrado em Medicina (Cirurgia Geral), apresentado á Faculdade de Medicina da Universidade de CoimbraIntroduction: Advances on neoadjuvant chemotherapy (NCT) have allowed surgical treatment in otherwise unresectable patients with colorectal liver metastases (CRLM). It is well known that NCT induces liver lesions such as sinusoidal obstruction syndrome (SOS) and steatohepatitis (SH). However, whether it affects postoperative morbidity remains controversial. The aim of this study was both to evaluate the impact of NCT on liver parenchyma and postoperative morbidity and to identify preoperative predictive markers for liver injury. Patients and Methods: Among 140 patients undergoing liver resection for CRLM between 2010 and 2013, 70 underwent systemic NCT. Liver function tests, pathology, postoperative morbidity and mortality were compared between the two groups. Results: Univariate analysis revealed NCT as a cause of sinusoidal dilation (p=0.09), peliosis (p=0.028), NRH (p=0.049) and moderate to severe SOS (p=0.004) and bevacizumab as a protective agent against moderate to severe SOS (p=0.045). Diabetic patients were identified as having a lower incidence of sinusoidal dilation (p=0.034). Multivariate analysis confirmed sinusoidal dilation as an independent cause for morbidity (p=0.02) and liver-specific complications (p=0.016). Preoperative level of GGT was identified as predictive factor for moderate to severe SOS and peliosis (p<0.001 and p=0.004, respectively). Conclusion: The administration of NCT induces SOS lesions, but can be partially prevented by bevacizumab. Sinusoidal dilation is an individual cause of postoperative morbidity. Preoperative GGT level can be used to predict the presence of SOS2015info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesishttp://hdl.handle.net/10316/30731http://hdl.handle.net/10316/30731TID:201627965engMartins, João Miguel Alvesinfo:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2022-01-20T17:48:43Zoai:estudogeral.uc.pt:10316/30731Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T20:44:37.036301Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Chemotherapy hepatotoxicity : histologic injury and impact on motbility after hepatectomy for colorectal cancer liver metastases
title Chemotherapy hepatotoxicity : histologic injury and impact on motbility after hepatectomy for colorectal cancer liver metastases
spellingShingle Chemotherapy hepatotoxicity : histologic injury and impact on motbility after hepatectomy for colorectal cancer liver metastases
Martins, João Miguel Alves
Neoplasias colorrectais
Quimioterapia
title_short Chemotherapy hepatotoxicity : histologic injury and impact on motbility after hepatectomy for colorectal cancer liver metastases
title_full Chemotherapy hepatotoxicity : histologic injury and impact on motbility after hepatectomy for colorectal cancer liver metastases
title_fullStr Chemotherapy hepatotoxicity : histologic injury and impact on motbility after hepatectomy for colorectal cancer liver metastases
title_full_unstemmed Chemotherapy hepatotoxicity : histologic injury and impact on motbility after hepatectomy for colorectal cancer liver metastases
title_sort Chemotherapy hepatotoxicity : histologic injury and impact on motbility after hepatectomy for colorectal cancer liver metastases
author Martins, João Miguel Alves
author_facet Martins, João Miguel Alves
author_role author
dc.contributor.author.fl_str_mv Martins, João Miguel Alves
dc.subject.por.fl_str_mv Neoplasias colorrectais
Quimioterapia
topic Neoplasias colorrectais
Quimioterapia
description Trabalho final de mestrado integrado em Medicina (Cirurgia Geral), apresentado á Faculdade de Medicina da Universidade de Coimbra
publishDate 2015
dc.date.none.fl_str_mv 2015
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/masterThesis
format masterThesis
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://hdl.handle.net/10316/30731
http://hdl.handle.net/10316/30731
TID:201627965
url http://hdl.handle.net/10316/30731
identifier_str_mv TID:201627965
dc.language.iso.fl_str_mv eng
language eng
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.source.none.fl_str_mv reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron:RCAAP
instname_str Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron_str RCAAP
institution RCAAP
reponame_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
collection Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
repository.name.fl_str_mv Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
repository.mail.fl_str_mv
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