Frequency of Chronic Liver Disease Due to Chemotherapy-Associated Liver Injury in Patients with Gastrointestinal Cancers.

IF 1.6 Q4 ONCOLOGY

Journal of Gastrointestinal Cancer Pub Date : 2025-07-16 DOI:10.1007/s12029-025-01281-1

Fernanda Sales Melo Mendes, Gabriel Martins Nogueira, Beatriz de Almeida Cunha, Liana Codes, Vivianne Mello, Anelisa Coutinho, Paulo Lisboa Bittencourt

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引用次数: 0

Abstract

Background: Chronic liver disease (CLD) has been reported in long-term survivors of gastrointestinal (GI) cancers treated with irinotecan- and/or oxaliplatin-based chemotherapy. This study aims to investigate the frequency and clinical consequences of CLD in GI cancer patients treated with chemotherapy and its potential impact on survival.

Methods: We retrospectively reviewed patients with GI cancers treated at AMO Oncology Clinic from 2017 to 2022. CLD evaluation was performed in patients without prior liver disease who survived ≥ 12 months after chemotherapy. Diagnosis was based on imaging findings of cirrhosis or portal hypertension (PH), histologic evidence of advanced fibrosis, or esophagogastric varices on endoscopy.

Results: A total of 328 patients (165 males; mean age 64 ± 13 years) were included. Most had colorectal cancer (58%) and TNM stage III or IV disease (69.6%). They received a median of 15.5 (8-28) chemotherapy cycles, mainly with oxaliplatin (86%), 5-fluorouracil (76%), irinotecan (49%), and capecitabine (43%). After a mean follow-up of 30.5 (21-49) months, CLD was identified in 47 patients (14.3%). Overall survival did not differ significantly between those with and without CLD (77.0 [51-102] vs. 85.7 [69-102] months, p = 0.385). CLD was associated with a greater number of chemotherapy agents (4 vs. 3, p = 0.002), cycles (21 vs. 13, p = 0.005), and exposure to 5-FU (89% vs. 73%, p = 0.02) and irinotecan (66% vs. 46%, p = 0.01).

Conclusions: Among patients with GI cancer receiving chemotherapy, CLD was relatively frequent but no difference in survival was observed. As PH complications may occur, screening for CLD should be recommended for long-term survivors.

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胃肠道肿瘤患者化疗相关肝损伤所致慢性肝病的发生率

背景：慢性肝脏疾病（CLD）在胃肠道（GI）癌症的长期幸存者中有报道，他们接受伊立替康和/或奥沙利铂为基础的化疗。本研究旨在探讨接受化疗的胃肠道肿瘤患者发生CLD的频率、临床后果及其对生存的潜在影响。方法：回顾性分析2017年至2022年在AMO肿瘤诊所治疗的胃肠道肿瘤患者。CLD评估在化疗后存活≥12个月的无肝脏疾病患者中进行。诊断是基于影像学发现肝硬化或门脉高压（PH），组织学证据晚期纤维化，或食管胃静脉曲张内镜。结果：共328例患者(男性165例；平均年龄（64±13岁）。大多数患有结直肠癌（58%）和TNM III期或IV期疾病（69.6%）。他们接受了15.5（8-28）个化疗周期，主要是奥沙利铂（86%）、5-氟尿嘧啶（76%）、伊立替康（49%）和卡培他滨（43%）。平均随访30.5（21-49）个月后，47例（14.3%）患者被确诊为CLD。有和没有CLD的患者的总生存期无显著差异（77.0[51-102]对85.7[69-102]个月，p = 0.385）。CLD与更多的化疗药物（4比3，p = 0.002）、周期（21比13，p = 0.005）、暴露于5-FU（89%比73%，p = 0.02）和伊立替康（66%比46%，p = 0.01）相关。结论：在接受化疗的胃肠道肿瘤患者中，CLD较为常见，但生存率无差异。由于可能发生PH并发症，建议长期存活的患者进行CLD筛查。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Gastrointestinal Cancer ONCOLOGY-

CiteScore

3.80

自引率

0.00%

发文量

121

期刊介绍： The Journal of Gastrointestinal Cancer is a multidisciplinary medium for the publication of novel research pertaining to cancers arising from the gastrointestinal tract.The journal is dedicated to the most rapid publication possible.The journal publishes papers in all relevant fields, emphasizing those studies that are helpful in understanding and treating cancers affecting the esophagus, stomach, liver, gallbladder and biliary tree, pancreas, small bowel, large bowel, rectum, and anus. In addition, the Journal of Gastrointestinal Cancer publishes basic and translational scientific information from studies providing insight into the etiology and progression of cancers affecting these organs. New insights are provided from diverse areas of research such as studies exploring pre-neoplastic states, risk factors, epidemiology, genetics, preclinical therapeutics, surgery, radiation therapy, novel medical therapeutics, clinical trials, and outcome studies.In addition to reports of original clinical and experimental studies, the journal also publishes: case reports, state-of-the-art reviews on topics of immediate interest or importance; invited articles analyzing particular areas of pancreatic research and knowledge; perspectives in which critical evaluation and conflicting opinions about current topics may be expressed; meeting highlights that summarize important points presented at recent meetings; abstracts of symposia and conferences; book reviews; hypotheses; Letters to the Editors; and other items of special interest, including:Complex Cases in GI Oncology: This is a new initiative to provide a forum to review and discuss the history and management of complex and involved gastrointestinal oncology cases. The format will be similar to a teaching case conference where a case vignette is presented and is followed by a series of questions and discussion points. A brief reference list supporting the points made in discussion would be expected.