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Background <p>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.</p> Methods <p>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&#xa0;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.</p> Results <p>A total of 328 patients (165 males; mean age 64 ± 13&#xa0;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, <i>p</i> = 0.385). CLD was associated with a greater number of chemotherapy agents (4 vs. 3, <i>p</i> = 0.002), cycles (21 vs. 13, <i>p</i> = 0.005), and exposure to 5-FU (89% vs. 73%, <i>p</i> = 0.02) and irinotecan (66% vs. 46%, <i>p</i> = 0.01).</p> Conclusions <p>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.</p>

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

  • 期刊论文

  • 发表日期：

    2025年7月16日

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

摘要

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.