Prevention of the Hepatic Sinusoidal Obstruction Syndrome Secondary to Oxaliplatin-based Neoadjuvant Chemotherapy for Colorectal Liver Metastases by Means of Anticoagulants
Surgical resection remains the only curative treatment for patients suffering from
colorectal liver metastases, but only 15-25% of patients are initially eligible for
resection. The majority of patients suffering from colorectal liver metastases receives
chemotherapy prior to liver surgery in order to downsize the colorectal liver metastases.
Preoperative treatment with oxaliplatin-based chemotherapy is related to sinusoidal injury,
the so-called sinusoidal obstruction syndrome. Patients with histologically proven
sinusoidal injury undergoing liver surgery have a higher risk of post-resectional morbidity.
Damage to the hepatic sinusoids is a key factor for the development of the sinusoidal
obstruction syndrome. Anticoagulants (i.e. salicylates, clopidogrel, low-molecular weight
heparin, or coumarin derivates) might be able to prevent this damage and, consequently, the
development of the sinusoidal obstruction syndrome in patients suffering from colorectal
liver metastases treated with neoadjuvant chemotherapy.
Observational Model: Cohort, Time Perspective: Retrospective
Histologically proven hepatic sinusoidal injury
during liver surgery
Steven WM Olde Damink, MD, PhD, MSc
Maastricht University Medical Centre
Netherlands: The Central Committee on Research Involving Human Subjects (CCMO)