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    Prospective study of change in liver function and fat in patients with colorectal liver metastases undergoing preoperative chemotherapy: protocol for the CLiFF Study

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    Authors
    Parmar, K. L.
    O'Reilly, D.
    Valle, Juan W
    Braun, Michael S
    Naish, J. H.
    Williams, S. R.
    Lloyd, W. K.
    Malcomson, Lee
    Bamford, C.
    Renehan, Andrew G
    Cresswell, K
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    Affiliation
    Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester,
    Issue Date
    2020
    
    Metadata
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    Abstract
    Introduction: Preoperative chemotherapy in patients undergoing resection for colorectal liver metastases (CLM) improves oncological outcomes. However, chemotherapy-associated liver injury (occurring in two patterns: vascular and fat deposition) is a real clinical concern prior to hepatic resection. After major liver resection, regeneration of the residual liver is a prerequisite for recovery and avoidance of liver failure, but this regenerative capacity may be hindered by chemotherapy. Thus, there is a need to predict for this serious complication. Over the past two decades, several tests and derived indices have been developed, which have failed to achieve clinical utility, mainly as they were indirect measurements of liver function. Here, we will use a novel test of liver function (the liver maximum capacity (LiMAx) test), and measure liver fat using MRI. Methods and analysis: This prospective study will assess changes in liver function longitudinally, measured by the LiMAx test, and liver fat, measured by advanced MRI using both MR spectroscopy and the modified Dixon method, in up to 35 patients undergoing preoperative chemotherapy for CLM. The primary outcomes will be the changes in liver function and fat compared with baseline prechemotherapy measurements. Secondary outcome measures include: routinely measured liver function blood tests, anthropometric measurements, postoperative histology and digital quantification of fat, postoperative complications and mortality and quality of life. Ethics and dissemination: The study was approved by a National Health Service Research Ethics Committee and registered with the Health Research Authority. Dissemination will be via international and national conferences and the National Institute for Health Research network. Manuscripts will be published.
    Citation
    Parmar KL, O'Reilly D, Valle JW, Braun M, Naish JH, Williams SR, et al. Prospective study of change in liver function and fat in patients with colorectal liver metastases undergoing preoperative chemotherapy: protocol for the CLiFF Study. BMJ Open. 2020;10(9):e027630.
    Journal
    BMJ Open
    URI
    http://hdl.handle.net/10541/623423
    DOI
    10.1136/bmjopen-2018-027630
    PubMed ID
    32967864
    Additional Links
    https://dx.doi.org/10.1136/bmjopen-2018-027630
    Type
    Article
    Language
    en
    ae974a485f413a2113503eed53cd6c53
    10.1136/bmjopen-2018-027630
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