According to a new study published in the Journal of the American College of Surgeons, researchers have found that having liver metastases and receiving chemotherapy are associated with higher splenic volume in patients with metastatic colorectal cancer, and the splenic volume increase is independently linked with major postoperative complications following hepatic resection.
For the study, researchers enrolled 80 patients with metastatic colorectal cancer and liver metastases who underwent hepatic resection. Of those, half received chemotherapy for 6 months before surgery while the other half did not receive preoperative chemotherapy. The patients who received preoperative chemotherapy were also compared to a group of 40 patients with benign disease who underwent cholecystectomy and a group of 40 patients with untreated non-metastatic colorectal cancer.
Results showed that the study group had significantly higher splenic volumes compared with the patients with benign disease (p < 0.001) and the patients with non-metastatic disease (p < 0.05) before chemotherapy. After 6 months of chemotherapy, the study group's splenic volumes were even higher, and the elevation was linked with any complication during surgery (p < 0.01) and major postoperative complications (p < 0.05).
Furthermore, patients with a 39% or higher increase in splenic volume were statistically significantly more likely to develop major complications after hepatic resection (p < 0.01). Of note, the researchers found no association between splenic volume increase and change in platelet count.
The present study investigates the relationship between change in splenic volume after preoperative chemotherapy and development of postoperative complications. In patients with colorectal cancer liver metastases (CRCLM), the presence of liver metastases and chemotherapy is associated with higher splenic volume.