Prediction of Esophagogastric Varices Associated with Oxaliplatin Administration

Abstract

\n Background: Oxaliplatin is a key drug for the chemotherapy of colorectal cancer; however, it is also known to cause non-cirrhotic portal hypertension. We aimed to identify the characteristics of patients who developed esophagogastric varices (EGV) after treatment with oxaliplatin.Methods: This study retrospectively analysed patients with colorectal cancer who were treated with chemotherapy including oxaliplatin between 2010 and 2016. All patients were evaluated by contrast-enhanced computed tomography (CT) every 3 months both during and after treatment, and endoscopy was performed when appearance of portal hypertension was suspected.Results: A total of 106 patients were divided into 2 groups: EGV formation (n=6) and EGV non-formation (n=100). In the EGV group, platelet counts decreased and the size of the spleen calculated by CT (CT-SI) increased markedly. The highest area under the receiver operating characteristic curve (AUC) for the change in platelet counts was 0.81 (80% sensitivity and 83% specificity) at 3 months posttreatment and the maximum AUC for CT-SI was 0.89 (79% sensitivity and 83% specificity) at 6 months posttreatment.Conclusions: EGV formation could be predicted by assessment of platelet counts and CT-SI not only during but also after completion of the treatment.