Title :

Conventional cytotoxic chemotherapy for gastrointestinal cancer in patients with cirrhosis: A multicentre case-control study.

Author(s) :

Ningarhari, Massih [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Institute for Translational Research in Inflammation - U 1286 [INFINITE]
Bertez, Marlène [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Ploquin, Anne [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Hétérogénéité, Plasticité et Résistance aux Thérapies des Cancers = Cancer Heterogeneity, Plasticity and Resistance to Therapies - UMR 9020 - U 1277 [CANTHER]
Bertrand, Nicolas [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Hétérogénéité, Plasticité et Résistance aux Thérapies des Cancers = Cancer Heterogeneity, Plasticity and Resistance to Therapies - UMR 9020 - U 1277 [CANTHER]
Desauw, Christophe [Auteur]
Hétérogénéité, Plasticité et Résistance aux Thérapies des Cancers = Cancer Heterogeneity, Plasticity and Resistance to Therapies - UMR 9020 - U 1277 [CANTHER]
Cattan, Stéphane [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Service des Maladies de l'Appareil Digestif et de la Nutrition [CHRU Lille]
Catala, Pascale [Auteur]
Centre Hospitalier de Béthune [CH Béthune]
Vandamme, Hélène [Auteur]
Centre Hospitalier de Béthune [CH Béthune]
Cheymol, Claire [Auteur]
Groupement des Hôpitaux de l'Institut Catholique de Lille [GHICL]
Truant, Stéphanie [Auteur]
Hétérogénéité, Plasticité et Résistance aux Thérapies des Cancers = Cancer Heterogeneity, Plasticity and Resistance to Therapies - UMR 9020 - U 1277 [CANTHER]
Service de chirurgie hepato-pancreato-biliaire
Lassailly, Guillaume [Auteur]
Lille Inflammation Research International Center - U 995 [LIRIC]
Institute for Translational Research in Inflammation - U 1286 [INFINITE]
Louvet, Alexandre [Auteur]
Lille Inflammation Research International Center - U 995 [LIRIC]
Institute for Translational Research in Inflammation - U 1286 [INFINITE]
Mathurin, Philippe [Auteur]
Lille Inflammation Research International Center - U 995 [LIRIC]
Institute for Translational Research in Inflammation - U 1286 [INFINITE]
Dharancy, Sebastien [Auteur]
Lille Inflammation Research International Center - U 995 [LIRIC]
Institute for Translational Research in Inflammation - U 1286 [INFINITE]
Turpin, Anthony [Auteur]
Hétérogénéité, Plasticité et Résistance aux Thérapies des Cancers = Cancer Heterogeneity, Plasticity and Resistance to Therapies - UMR 9020 - U 1277 [CANTHER]

Journal title :

Liver International

Pages :

682-690

Publisher :

Wiley-Blackwell

Publication date :

2023-12-01

ISSN :

1478-3223

English keyword(s) :

chemotherapy
cirrhosis
gastrointestinal cancer
safety

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

Background & Aims: Progresses in management make a higher proportion of cir-rhotic patients with gastrointestinal (GI) cancer candidates to chemotherapy. Data are needed on the safety and liver-related events associated ...
Show more >Background & Aims: Progresses in management make a higher proportion of cir-rhotic patients with gastrointestinal (GI) cancer candidates to chemotherapy. Data are needed on the safety and liver-related events associated with the use of chemo-therapy in these patients.Methods: Forty-nine patients with cirrhosis receiving chemotherapy against GI can-cer from 2013 to 2018 were identified in the French Health Insurance Database using ICD-10 codes K70-K74, and matched 1:2 to non-cirrhotic controls (n= 98) on age, tu-mour type and type of treatment. Adverse events (AE), dose tapering, discontinuation rate, liver-related events and survival rate were compared.Results: Patients with cirrhosis (Child–Pugh A 91%) more often received lower doses (38.8% vs 7.1%, p< .001), without significant differences in terms of grade 3/4 AE or dose tapering rates (29.6% vs. 36.7%; 22.3% vs 24.4%, respectively). Treatment discontinuation rate was higher in patients with cirrhosis (23.3% vs. 11.3%, p= .005). Child–Pugh (p= .007) and MELD (p= .025) scores increased under chemotherapy. Five patients with cirrhosis (10.2%) had liver decompensation within 12 months, and 17.2% of deaths in the cirrhosis group were liver-related versus 0% in matched controls. WHO-PS stage > 1 (HR 3.74, CI95%: 2.13–6.57, p< .001), TNM-stage M1 (HR 3.61, CI 95%: 1.82–7.16, p< .001), non-colorectal cancer (HR 1.73, CI 95%: 1.05–2.86, p= .032) and bilirubin higher than 5 mg/dL (HR 2.26, CI 95%: 1.39–3.70, p< .001) were inde-pendent prognostic factors of 2-year mortality, whereas cirrhosis was not.Conclusions: Chemotherapy should be proposed only in patients with compensated cirrhosis with close monitoring of liver function. Dose management remains challeng-ing. Multidisciplinary management is warranted to improve these patients' outcomes.Show less >

Language :

Anglais

Peer reviewed article :

Oui

Audience :

Internationale

Popular science :

Non

Collections :

• Cancer Heterogeneity, Plasticity and Resistance to Therapies (CANTHER) - UMR 9020 - UMR 1277

Source :

Harvested from HAL