ArticleHepatobiliary surgery and nutrition2025
Splenic hypertrophy predicts liver-specific complications in patients undergoing major liver resection for colorectal liver metastases, after preoperative chemotherapy.
Article in Hepatobiliary surgery and nutrition, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- A Comparison of 11 Clinical Risk Scores for Prediction of Survival After Curative-Intent Resection of Colorectal Liver Metastases.Annals of surgical oncology · 2026Article
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Abstract
Background: In patients with colorectal liver metastases (CRLM), preoperative chemotherapy may increase resectability and survival outcomes. However, cytotoxic agents can also cause chemotherapy-associated liver injury (CALI), leading to increased rates of postoperative complications. This study evaluates the association between splenic hypertrophy (SH) after preoperative chemotherapy and postoperative liver-specific complications (LSC), in patients undergoing major liver resection for CRLM. Methods: This retrospective study included patients who underwent major curative liver resection of CRLM following preoperative chemotherapy at the University Hospital RWTH Aachen (UH-RWTH) between 2010-2021. Patients with missing radiological images, incomplete data on chemotherapy regimens, or prior splenectomy were excluded. Volumetric measurements of the spleen were performed on preoperative computerized tomography (CT) and magnetic resonance imaging (MRI) images, using segmentation software (3D-Slicer). Receiver-operating characteristic (ROC) analysis was performed to determine the optimal SH cut-off for predicting postoperative LSC. Independent risk factors of postoperative LSC were examined using logistic regression. Results: A total of 115 patients were included in the study, of which 78 (68%) received oxaliplatin as part of their preoperative chemotherapy regimen. A threshold of 8.6% SH (Youden Index =0.25) was identified as predictive of postoperative LSC. Patients with SH >8.6% (n=62) received oxaliplatin significantly more often (84% Conclusions: Preoperative SH may be a valuable predictor of postoperative LSC in patients undergoing major liver resection for CRLM, following chemotherapy. Further studies are necessary to investigate the impact on a larger cohort and find preventive strategies to mitigate and treat CALI.
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