Splenic volume as a biomarker of hepatic damage after chemotherapy in patients with resected colorectal liver metastases (CRLM)

  • P. Saez-CarlinEmail author
  • A. García-Botella
  • L. I. Diez-Valladares
  • L. Ortega Medina
  • R. Méndez
  • J. C. M. González
  • I. Bernal
  • I. Serrano García
  • R. Avellana
  • A. J. Torres García
Research Article



Chemotherapy-associated liver injury (CALI) is a matter of concern for hepatobiliary surgeons as it can entail postoperative liver failure after an extensive hepatectomy. Recent studies have taken special interest in liver function parameters which can correlate with CALI to decrease this adverse event. Therefore, the current study investigates the usefulness of splenic volume as a biomarker of CALI through a portal hypertension mechanism, in patients with colorectal liver metastases (CRLM).

Study design

We carried out a study in patients with CRLM operated on between 2009 and 2014 in our center. All samples of healthy liver were graded for non-alcoholic fatty liver disease (NAFLD) and sinusoidal obstructive syndrome. Computarized tomography scans for spleen volumetry were analyzed for each patient at CRLM diagnosis, after neoadjuvant chemotherapy, 1 and 6 months after resection.


A group of 65 consecutive patients with CRLM of large bowel adenocarcinoma submitted to liver resection were included. Patients receiving neoadjuvant chemotherapy had a greater spleen volume increase than those who did not receive treatment (p = 0.053), finding a statistically significant spleen growth in patients with NAFLD (p = 0.036). There was no correlation between spleen enlargement and postoperative complications or average stay. However, survival was decreased in patients with spleen growth and CALI.


Patients who receive neoadjuvant chemotherapy for liver metastasis surgery have a greater splenic volume increase, which correlates with NAFLD and a lower survival.


Chemotherapy Liver injury Colorectal cancer Metastases Spleen 



Chemotherapy-associated liver injury


Colorectal cancer


Colorectal liver metastases


Non-alcoholic fatty liver disease


Sinusoidal obstruction syndrome


Compliance with ethical standards

Conflict of interest

The authors declare that they have no competing interest.

Ethical approval

The Institutional Review Board at Hospital Clínico San Carlos approved this study (Ethical Committee Code: 16/485-E_Tesis).

Informed consent

The retrospective study design was approved by the Hospital's ethics committee and written patients' consent was not required.


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Copyright information

© Federación de Sociedades Españolas de Oncología (FESEO) 2019

Authors and Affiliations

  • P. Saez-Carlin
    • 1
    Email author
  • A. García-Botella
    • 1
  • L. I. Diez-Valladares
    • 1
  • L. Ortega Medina
    • 2
  • R. Méndez
    • 3
  • J. C. M. González
    • 3
  • I. Bernal
    • 2
  • I. Serrano García
    • 4
  • R. Avellana
    • 1
  • A. J. Torres García
    • 1
  1. 1.HBP Department of General SurgeryHospital Clínico San CarlosMadridSpain
  2. 2.Pathology DepartmentHospital Clínico San CarlosMadridSpain
  3. 3.Radiology DepartmentHospital Clínico San CarlosMadridSpain
  4. 4.Statistics DepartmentHospital Clínicon San CarlosMadridSpain

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