Advertisement

Clinical Journal of Gastroenterology

, Volume 11, Issue 6, pp 487–492 | Cite as

Esophagogastric varices were diagnosed in a non-cirrhotic liver case during long-term follow-up after oxaliplatin-based chemotherapy

  • Ryuta Shigefuku
  • Tsunamasa Watanabe
  • Takuro Mizukami
  • Kotaro Matsunaga
  • Nobuhiro Hattori
  • Takuya Ehira
  • Tatsuya Suzuki
  • Hiroyasu Nakano
  • Yoshinori Sato
  • Yasumasa Matsuo
  • Kazunari Nakahara
  • Hiroki Ikeda
  • Nobuyuki Matsumoto
  • Takashi Tsuda
  • Masafumi Katayama
  • Satoshi Koizumi
  • Chiaki Okuse
  • Michihiro Suzuki
  • Takehito Otsubo
  • Takako Eguchi Nakajima
  • Hiroshi Yasuda
  • Fumio Itoh
Case Report
  • 57 Downloads

Abstract

Oxaliplatin, a chemotherapeutic agent for colorectal cancer, has been associated with pathological evidence of sinusoidal endothelial injury in the liver. However, esophagogastric varices are a poorly recognized outcome of oxaliplatin-based chemotherapy. We report a 78-year-old man, whose past history of colon cancer was resection and treatment with mFOLFOX6 for 20 weeks, as adjuvant chemotherapy. After 3.5-year follow-up of the oxaliplatin-based chemotherapy, he was diagnosed with esophageal varices without liver dysfunction, indicating that the hepatotoxicity caused by oxaliplatin could be prolonged after its administration. Patients who have received oxaliplatin-based chemotherapy should be followed up carefully over the long term.

Keywords

Esophagogastric varices Oxaliplatin Hepatotoxicity Sinusoidal obstruction syndrome (SOS) Non-cirrhosis 

Notes

Acknowledgements

This study was supported, in part, by a grant-in-aid from the Ministry of Health, Labour, and Welfare of Japan, and a grant-in-aid from the Ministry of Education, Culture, Sports, Science and Technology, Japan.

Compliance with ethical standards

Conflict of interest

The authors state that they have no conflict of interest.

References

  1. 1.
    Kullak-Ublick GA, Andrade RJ, Merz M, et al. Drug-induced liver injury: recent advances in diagnosis and risk assessment. Gut. 2017;66:1154–64.CrossRefGoogle Scholar
  2. 2.
    Fan CQ, Crawford JM. Sinusoidal obstruction syndrome (hepatic veno-occlusive disease). J Clin Exp Hepatol. 2014;4:332–46.CrossRefGoogle Scholar
  3. 3.
    Narita M, Oussoultzoglou E, Chenard MP, et al. Liver injury due to chemotherapy-induced sinusoidal obstruction syndrome is associated with sinusoidal capillarization. Ann Surg Oncol. 2012;19:2230–7.CrossRefGoogle Scholar
  4. 4.
    Nakano H, Oussoultzoglou E, Rosso E, et al. Sinusoidal injury increases morbidity after major hepatectomy in patients with colorectal liver metastases receiving preoperative chemotherapy. Ann Surg. 2008;247:118–24.CrossRefGoogle Scholar
  5. 5.
    Komori H, Beppu T, Baba Y, et al. Histological liver injury and surgical outcome after FOLFOX followed by a hepatectomy for colorectal liver metastases in Japanese patients. Int J Clin Oncol. 2010;15:263–70.CrossRefGoogle Scholar
  6. 6.
    Rubbia-Brandt L, Audard V, Sartoretti P, et al. Severe hepatic sinusoidal obstruction associated with oxaliplatin-based chemotherapy in patients with metastatic colorectal cancer. Ann Oncol. 2004;15:460–6.CrossRefGoogle Scholar
  7. 7.
    Prassopoulos P, Daskalogiannaki M, Raissaki M, et al. Determination of normal splenic volume on computed tomography in relation to age, gender and body habitus. Eur Radiol. 1997;7:246–8.CrossRefGoogle Scholar
  8. 8.
    Tajiri T, Yoshida H, Obara K, et al. General rules for recording endoscopic findings of esophagogastric varices (2nd ed). Dig Endosc. 2010;22:1–9.CrossRefGoogle Scholar
  9. 9.
    Kalofonos HP, Aravantinos G, Kosmidis P, et al. Irinotecan or oxaliplatin combined with leucovorin and 5-fluorouracil as first-line treatment in advanced colorectal cancer: a multicenter, randomized, phase II study. Ann Oncol. 2005;16:869–77.CrossRefGoogle Scholar
  10. 10.
    Fernandez FG, Ritter J, Goodwin JW, et al. Effect of steatohepatitis associated with irinotecan or oxaliplatin pretreatment on resectability of hepatic colorectal metastases. J Am Coll Surg. 2005;200:845–53.CrossRefGoogle Scholar
  11. 11.
    Vauthey JN, Pawlik TM, Ribero D, et al. Chemotherapy regimen predicts steatohepatitis and an increase in 90-day mortality after surgery for hepatic colorectal metastases. J Clin Oncol. 2006;24:2065–72.CrossRefGoogle Scholar
  12. 12.
    Morine Y, Shimada M, Utsunomiya T. Evaluation and management of hepatic injury induced by oxaliplatin-based chemotherapy in patients with hepatic resection for colorectal liver metastasis. Hepatol Res. 2014;44:59–69.CrossRefGoogle Scholar
  13. 13.
    Ortiz Morales CM, Arraiza Sarasa M, Benito Boillos A, et al. Direct embolization of stomal varices in portal hypertension after the treatment of liver metastases. Radiologia. 2010;52:556–9.CrossRefGoogle Scholar
  14. 14.
    Shigefuku R, Takahashi H, Tsuda T, et al. Two cases of rupture of esophagogastric varices during the course of oxaliplatin-based chemotherapy for colorectal cancer. Nihon Shokakibyo Gakkai Zasshi. 2014;111:2326–36.PubMedGoogle Scholar
  15. 15.
    Lawal TO, Farris AB, El-Rayes BF, et al. Oxaliplatin-induced hepatoportal sclerosis, portal hypertension, and variceal bleeding successfully treated with transjugular intrahepatic portosystemic shunt. Clin Colorectal Cancer. 2012;11:224–7.CrossRefGoogle Scholar
  16. 16.
    Slade JH, Alattar ML, Fogelman DR, et al. Portal hypertension associated with oxaliplatin administration: clinical manifestations of hepatic sinusoidal injury. Clin Colorectal Cancer. 2009;8:225–30.CrossRefGoogle Scholar
  17. 17.
    Deleve LD, Wang X, Tsai J, et al. Sinusoidal obstruction syndrome (veno-occlusive disease) in the rat is prevented by matrix metalloproteinase inhibition. Gastroenterology. 2003;125:882–90.CrossRefGoogle Scholar
  18. 18.
    You SH, Park BJ, Kim YH. Hepatic lesions that mimic metastasis on radiological imaging during chemotherapy for gastrointestinal malignancy: recent updates. Korean J Radiol. 2017;18:413–26.CrossRefGoogle Scholar
  19. 19.
    Robinson SM, Mann J, Vasilaki A, et al. Pathogenesis of FOLFOX induced sinusoidal obstruction syndrome in a murine chemotherapy model. J Hepatol. 2013;59:318–26.CrossRefGoogle Scholar
  20. 20.
    Vigano L, De Rosa G, Toso C, et al. Reversibility of chemotherapy-related liver injury. J Hepatol. 2017;67:84–91.CrossRefGoogle Scholar
  21. 21.
    Overman MJ, Maru DM, Charnsangavej C, et al. Oxaliplatin-mediated increase in spleen size as a biomarker for the development of hepatic sinusoidal injury. J Clin Oncol. 2010;28:2549–55.CrossRefGoogle Scholar
  22. 22.
    Iwai T, Yamada T, Koizumi M, et al. Oxaliplatin-induced increase in splenic volume; irreversible change after adjuvant FOLFOX. J Surg Oncol. 2017;116:947–53.CrossRefGoogle Scholar
  23. 23.
    Yamasaki K, Tateyama M, Abiru S, et al. Elevated serum levels of Wisteria floribunda agglutinin-positive human Mac-2 binding protein predict the development of hepatocellular carcinoma in hepatitis C patients. Hepatology. 2014;60:1563–70.CrossRefGoogle Scholar
  24. 24.
    Bekki Y, Yoshizumi T, Shimoda S, et al. Hepatic stellate cells secreting WFA(+)-M2BP: its role in biological interactions with Kupffer cells. J Gastroenterol Hepatol. 2017;32:1387–93.CrossRefGoogle Scholar
  25. 25.
    Miura K, Nakano H, Sakurai J, et al. Splenomegaly in FOLFOX-naive stage IV or recurrent colorectal cancer patients due to chemotherapy-associated hepatotoxicity can be predicted by the aspartate aminotransferase to platelet ratio before chemotherapy. Int J Clin Oncol. 2011;16:257–63.CrossRefGoogle Scholar
  26. 26.
    Tajima H, Ohta T, Miyashita T, et al. Oxaliplatin-based chemotherapy induces extravasated platelet aggregation in the liver. Mol Clin Oncol. 2015;3:555–8.CrossRefGoogle Scholar
  27. 27.
    Kim H, Choi D, Gwak GY, et al. Evaluation of esophageal varices on liver computed tomography: receiver operating characteristic analyses of the performance of radiologists and endoscopists. J Gastroenterol Hepatol. 2009;24:1534–40.CrossRefGoogle Scholar

Copyright information

© Japanese Society of Gastroenterology 2018

Authors and Affiliations

  • Ryuta Shigefuku
    • 1
  • Tsunamasa Watanabe
    • 1
  • Takuro Mizukami
    • 2
  • Kotaro Matsunaga
    • 1
  • Nobuhiro Hattori
    • 1
  • Takuya Ehira
    • 1
  • Tatsuya Suzuki
    • 1
  • Hiroyasu Nakano
    • 1
  • Yoshinori Sato
    • 1
  • Yasumasa Matsuo
    • 1
  • Kazunari Nakahara
    • 1
  • Hiroki Ikeda
    • 1
  • Nobuyuki Matsumoto
    • 1
  • Takashi Tsuda
    • 2
  • Masafumi Katayama
    • 3
  • Satoshi Koizumi
    • 3
  • Chiaki Okuse
    • 4
  • Michihiro Suzuki
    • 4
  • Takehito Otsubo
    • 3
  • Takako Eguchi Nakajima
    • 2
  • Hiroshi Yasuda
    • 1
  • Fumio Itoh
    • 1
  1. 1.Division of Gastroenterology and Hepatology, Department of Internal MedicineSt. Marianna University School of MedicineKawasakiJapan
  2. 2.Department of Clinical OncologySt. Marianna UniversityKawasakiJapan
  3. 3.Division of Gastroenterological and General SurgerySt. Marianna UniversityKawasakiJapan
  4. 4.Division of Gastroenterology and Hepatology, Department of Internal MedicineKawasaki Municipal Tama HospitalKawasakiJapan

Personalised recommendations