Authors: Srinevas K Reddy Colleen Reilly Min Zhan Ayse L Mindikoglu Yixing Jiang Barton F Lane H Richard Alexander William J Culpepper Samer S ElKamary
Publish Date: 2014/05/06
Volume: 31, Issue: 6, Pages: 971-
Abstract
To determine whether chemotherapy treatment at least 6 months prior to the detection of hepatic steatosis is associated with advanced hepatic fibrosis Demographics comorbid conditions and laboratory data for cancer patients with hepatic steatosis were reviewed The primary end point of this study was a low probability of fibrosis as calculated by the ASTtoplatelet ratio index APRI—a surrogate for the absence of histologic bridging fibrosis and/or cirrhosis Of 279 patients 117 419 were treated with chemotherapy and 197 663 had a low probability of fibrosis by APRI A smaller proportion of patients treated with chemotherapy had a low probability of hepatic fibrosis compared with untreated patients 641 vs 753 p = 004 On multivariable analysis chemotherapy treatment was a negative predictive factor for a low probability of fibrosis OR 0366 95 CI 0184–0708 p 001 Among chemotherapytreated patients 75 641 had a low probability of fibrosis There were no differences in chemotherapy duration mean 78 vs 75 cycles and interval from last dose to steatosis diagnosis 243 vs 214 months between patients with and without a low probability of fibrosis A smaller proportion of patients treated with irinotecan or 5fluorouracil had a low probability of fibrosis 373 vs 667 p = 004 On multivariable analysis irinotecan or 5fluorouracil treatment was a negative predictive factor for low probability of fibrosis OR 0277 95 CI 0091–0779 p = 002 Prior chemotherapy treatment especially with 5fluorouracil or irinotecan is a negative predictor for the absence of advanced hepatic fibrosis among patients with steatosisDr Reddy is supported by NIH 2K12HD04348911 Dr Mindikoglu is supported by NIH K23DK089008 The project described was supported in part by Grant Number 5 K23 DK08900804 from the National Institutes of Health NIH National Institute of Diabetes and Digestive and Kidney Diseases to Ayse L Mindikoglu MD MPH and its contents are solely the responsibility of the authors and do not necessarily represent the official views of the National Institute of Diabetes and Digestive and Kidney Diseases or the NIH
Keywords: