Objectives: To report the long-term follow-up data including computed tomography (CT) findings of oxaliplatin-induced liver damage in patients with colorectal cancer.
Methods: Three hundred and fifty-six patients who underwent surgery followed by oxaliplatin-based chemotherapy (OBC) for colorectal cancer between January 2013 and December 2014 were included. Abdominal CT images and laboratory results (serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), albumin, total bilirubin, and platelet counts) were reviewed immediately before (as baseline), during, and after adjuvant OBC. Abdominal CT images were reviewed to assess the heterogeneous liver parenchyma, increase in size of the spleen, development of acute portosystemic shunts during OBC, and imaging findings of chronic portal hypertension.
Results: During OBC, 90.2% (321/356) of the patients developed parenchymal heterogeneity. Increase in the spleen size during the OBC period was seen in 62.4% (225/356) of patients. The overall rate of development of acute portosystemic shunts during OBC was 23.9% (85/356). These findings were resolved after cessation of OBC except in 1.4% (5/356) of the patients in whom chronic portal hypertension persisted even after completion of OBC. Serum AST, ALT, and total bilirubin levels increased and platelet counts decreased during OBC and returned to normal after completion of OBC; however, they did not reach the pre-OBC levels.
Conclusion: Although most changes associated with liver damage reversed to normal range after completion of OBC, some parameters did not reverse to the pretreatment level, and chronic portal hypertension developed in a small number of patients.
Advances in knowledge: Chronic, persistent oxaliplatin-induced liver damage was not an infrequent complication after oxaliplatin-based chemotherapy for patients with colorectal cancer. It may cause non-cirrhotic portal hypertension and associated complications such as variceal bleeding.