Adjuvant FOLFOX chemotherapy and splenomegaly in patients with stages II-III colorectal cancer

Revathi Angitapalli, Alan Litwin, Prasanna R.G. Kumar, Eiad Nasser, Jeffrey Lombardo, Terry Mashtare, Gregory E. Wilding, Marwan G. Fakih

Research output: Contribution to journalArticle

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Abstract

Background: The impact of adjuvant chemotherapy on hepatic function and portal hypertension in patients with stages II-III colon cancer has not been previously described. We conducted a retrospective study to assess the effects of adjuvant FOLFOX chemotherapy on the splenic index (SI) as a surrogate marker for portal hypertension. Methods: Stage II-IIIcolorectal cancer patients treated with adjuvant FOLFOX or fluorouracil/leucovorin (5-FU/LV) at Roswell Park Cancer Institute between2002 and 2006were identified. Computerizedtomography (CT) scans obtained prior to and at completion of chemotherapy, and every 6 months thereafter were reviewed. Splenic size was evaluated using the SI (SI = length × width × height of the spleen). Results: 40 patientswere identified in the FOLFOX group and 23 in the 5-FU/LV group. After 6 months of adjuvant chemotherapy, the mean increase in SI was 45.7 and 16.3% in the FOLFOX and 5-FU/LV groups, respectively (p = 0.0069). SI increased by >100% in 6 patients (15%) in the FOLFOX group versus none in the 5-FU/LV group (p = 0.16). The mean SI at completion of adjuvant chemotherapy was significantly higher in the FOLFOX group than in the 5-FU/LV group (p = 0.007). The mean SI decreased steadily over a period of 2 years after discontinuation of FOLFOX, suggesting potential reversibility of oxaliplatin-induced hepatic injury in this setting. Conclusions: Adjuvant FOLFOX significantly increases the SI in patients with resected colorectal cancer in comparison to adjuvant 5-FU/LV. The increase in SI may be a marker of oxaliplatin-induced hepatic injury and should be investigated further in prospective longitudinal studies of oxaliplatin-based adjuvant chemotherapy.

Original languageEnglish (US)
Pages (from-to)363-368
Number of pages6
JournalOncology
Volume76
Issue number5
DOIs
StatePublished - Apr 1 2009

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Splenomegaly
Adjuvant Chemotherapy
oxaliplatin
Fluorouracil
Colorectal Neoplasms
Portal Hypertension
Liver
Leucovorin
Wounds and Injuries
Colonic Neoplasms
Longitudinal Studies
Neoplasms
Spleen
Retrospective Studies
Biomarkers
Prospective Studies
Drug Therapy

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

Cite this

Angitapalli, R., Litwin, A., Kumar, P. R. G., Nasser, E., Lombardo, J., Mashtare, T., ... Fakih, M. G. (2009). Adjuvant FOLFOX chemotherapy and splenomegaly in patients with stages II-III colorectal cancer. Oncology, 76(5), 363-368. https://doi.org/10.1159/000210025
Angitapalli, Revathi ; Litwin, Alan ; Kumar, Prasanna R.G. ; Nasser, Eiad ; Lombardo, Jeffrey ; Mashtare, Terry ; Wilding, Gregory E. ; Fakih, Marwan G. / Adjuvant FOLFOX chemotherapy and splenomegaly in patients with stages II-III colorectal cancer. In: Oncology. 2009 ; Vol. 76, No. 5. pp. 363-368.
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Angitapalli, R, Litwin, A, Kumar, PRG, Nasser, E, Lombardo, J, Mashtare, T, Wilding, GE & Fakih, MG 2009, 'Adjuvant FOLFOX chemotherapy and splenomegaly in patients with stages II-III colorectal cancer', Oncology, vol. 76, no. 5, pp. 363-368. https://doi.org/10.1159/000210025

Adjuvant FOLFOX chemotherapy and splenomegaly in patients with stages II-III colorectal cancer. / Angitapalli, Revathi; Litwin, Alan; Kumar, Prasanna R.G.; Nasser, Eiad; Lombardo, Jeffrey; Mashtare, Terry; Wilding, Gregory E.; Fakih, Marwan G.

In: Oncology, Vol. 76, No. 5, 01.04.2009, p. 363-368.

Research output: Contribution to journalArticle

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T1 - Adjuvant FOLFOX chemotherapy and splenomegaly in patients with stages II-III colorectal cancer

AU - Angitapalli, Revathi

AU - Litwin, Alan

AU - Kumar, Prasanna R.G.

AU - Nasser, Eiad

AU - Lombardo, Jeffrey

AU - Mashtare, Terry

AU - Wilding, Gregory E.

AU - Fakih, Marwan G.

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N2 - Background: The impact of adjuvant chemotherapy on hepatic function and portal hypertension in patients with stages II-III colon cancer has not been previously described. We conducted a retrospective study to assess the effects of adjuvant FOLFOX chemotherapy on the splenic index (SI) as a surrogate marker for portal hypertension. Methods: Stage II-IIIcolorectal cancer patients treated with adjuvant FOLFOX or fluorouracil/leucovorin (5-FU/LV) at Roswell Park Cancer Institute between2002 and 2006were identified. Computerizedtomography (CT) scans obtained prior to and at completion of chemotherapy, and every 6 months thereafter were reviewed. Splenic size was evaluated using the SI (SI = length × width × height of the spleen). Results: 40 patientswere identified in the FOLFOX group and 23 in the 5-FU/LV group. After 6 months of adjuvant chemotherapy, the mean increase in SI was 45.7 and 16.3% in the FOLFOX and 5-FU/LV groups, respectively (p = 0.0069). SI increased by >100% in 6 patients (15%) in the FOLFOX group versus none in the 5-FU/LV group (p = 0.16). The mean SI at completion of adjuvant chemotherapy was significantly higher in the FOLFOX group than in the 5-FU/LV group (p = 0.007). The mean SI decreased steadily over a period of 2 years after discontinuation of FOLFOX, suggesting potential reversibility of oxaliplatin-induced hepatic injury in this setting. Conclusions: Adjuvant FOLFOX significantly increases the SI in patients with resected colorectal cancer in comparison to adjuvant 5-FU/LV. The increase in SI may be a marker of oxaliplatin-induced hepatic injury and should be investigated further in prospective longitudinal studies of oxaliplatin-based adjuvant chemotherapy.

AB - Background: The impact of adjuvant chemotherapy on hepatic function and portal hypertension in patients with stages II-III colon cancer has not been previously described. We conducted a retrospective study to assess the effects of adjuvant FOLFOX chemotherapy on the splenic index (SI) as a surrogate marker for portal hypertension. Methods: Stage II-IIIcolorectal cancer patients treated with adjuvant FOLFOX or fluorouracil/leucovorin (5-FU/LV) at Roswell Park Cancer Institute between2002 and 2006were identified. Computerizedtomography (CT) scans obtained prior to and at completion of chemotherapy, and every 6 months thereafter were reviewed. Splenic size was evaluated using the SI (SI = length × width × height of the spleen). Results: 40 patientswere identified in the FOLFOX group and 23 in the 5-FU/LV group. After 6 months of adjuvant chemotherapy, the mean increase in SI was 45.7 and 16.3% in the FOLFOX and 5-FU/LV groups, respectively (p = 0.0069). SI increased by >100% in 6 patients (15%) in the FOLFOX group versus none in the 5-FU/LV group (p = 0.16). The mean SI at completion of adjuvant chemotherapy was significantly higher in the FOLFOX group than in the 5-FU/LV group (p = 0.007). The mean SI decreased steadily over a period of 2 years after discontinuation of FOLFOX, suggesting potential reversibility of oxaliplatin-induced hepatic injury in this setting. Conclusions: Adjuvant FOLFOX significantly increases the SI in patients with resected colorectal cancer in comparison to adjuvant 5-FU/LV. The increase in SI may be a marker of oxaliplatin-induced hepatic injury and should be investigated further in prospective longitudinal studies of oxaliplatin-based adjuvant chemotherapy.

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Angitapalli R, Litwin A, Kumar PRG, Nasser E, Lombardo J, Mashtare T et al. Adjuvant FOLFOX chemotherapy and splenomegaly in patients with stages II-III colorectal cancer. Oncology. 2009 Apr 1;76(5):363-368. https://doi.org/10.1159/000210025