Case Report
Copyright ©2006 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Oct 28, 2006; 12(40): 6556-6558
Published online Oct 28, 2006. doi: 10.3748/wjg.v12.i40.6556
Portal thrombosis and steatosis after preoperativechemotherapy with FOLFIRI-bevacizumab for colorectal liver metastases
Matteo Donadon, Jean-Nicolas Vauthey, Evelyne M Loyer, Chusilp Charnsangavej, Eddie K Abdalla
Matteo Donadon, Jean-Nicolas Vauthey, Eddie K Abdalla, The University of Texas, MD, Anderson Cancer Center, Department of Surgical Oncology, Houston, Texas 77030, United States
Evelyne M Loyer, Chusilp Charnsangavej, The University of Texas MD Anderson Cancer Center, Diagnostic Radiology, Houston, Texas 77030, United States
Correspondence to: Jean-Nicolas Vauthey, MD, Professor of Surgery, Chief, Liver Service, The University of Texas MD Anderson Cancer Center, Department of Surgical Oncology, Unit 444, 1515 Holcombe Boulevard, Houston, Texas 77030, United States. jvauthey@mdanderson.org
Telephone: +1-713-7922022 Fax: +1-713-7922022
Received: August 1, 2006
Revised: August 22, 2006
Accepted: September 13, 2006
Published online: October 28, 2006
Abstract

In order to discuss the role of preoperative chemo-therapy for colorectal liver metastases, which is used frequently before hepatic resection, even in patients with resectable disease at presentation, we herein report the development of two complications, partial portal vein thrombosis and hepatic steatosis with lobular inflammation, during the course of preoperative chemotherapy with FOLFIRI plus bevacizumab for colorectal liver metastases, which recognition led to timely discontinuation of chemotherapy as well as a change in the surgical strategy to resect the tumors and the damaged liver through advanced techniques. We conclude that duration of treatment and drug doses and combinations may impact the development of chemotherapy-induced liver injury. Surgeons and medical oncologists must work together to devise safe, rational, and oncologically appropriate treatments for patients with multiple colorectal liver metastases, and to improve the understanding of the pathogenesis of chemotherapy-induced liver injury.

Keywords: Chemotherapy; Colorectal liver metastases; Resection