Liver Abscesses in Cancer Patients Associated with Poor Prognosis: A Single Center Experience

Authors

  • Khosravi-Shahi Parham Servicio de Oncología Médica, Hospital General Universitario Gregorio Marañón, Madrid, Spain
  • Aparicio-Salcedo María Inmaculada Servicio de Oncología Médica, Hospital General Universitario Gregorio Marañón, Madrid, Spain
  • Alva-Bianchi Manuel Servicio de Oncología Médica, Hospital General Universitario Gregorio Marañón, Madrid, Spain
  • Arregui-Valles Marta Servicio de Oncología Médica, Hospital General Universitario Gregorio Marañón, Madrid, Spain
  • Morón-García Blanca Isabel Servicio de Oncología Médica, Hospital General Universitario Gregorio Marañón, Madrid, Spain
  • Tirado-Anula Victoria Clara Servicio de Oncología Médica, Hospital General Universitario Gregorio Marañón, Madrid, Spain
  • De Toro-Carmena María Servicio de Oncología Médica, Hospital General Universitario Gregorio Marañón, Madrid, Spain
  • Martínez-Delfrade Iñigo Servicio de Oncología Médica, Hospital General Universitario Gregorio Marañón, Madrid, Spain
  • González-del-Val Ricardo Servicio de Oncología Médica, Hospital General Universitario Gregorio Marañón, Madrid, Spain

DOI:

https://doi.org/10.30683/1929-2279.2019.08.07

Keywords:

Hepatic, Escherichia, Meropenem, Bacteremia, Cancer, Chemotherapy, Pancreatic Adenocarcinoma.

Abstract

Background: Liver abscesses are uncommon, but they are associated with a hospital mortality rate of 10% in patients without cancer. However, its relevance in cancer patients in terms of survival and length of hospitalization is unknown.

Patients and Methods: We conducted an observational study in order to analyze the impact of liver abscesses in hospitalized cancer patients. Eligible patients were adults with a solid tumor, received antineoplastic treatment and were hospitalized in our department with a diagnosis of liver abscesses. Primary end-points of the study were overall survival (OS) and mean hospital stay (MHS). Secondary end-points were the description of risk factors of liver abscesses, isolated microorganisms and the specific treatment.

Results: In our study the incidence of liver abscesses in cancer patients was 1.18%. Median age was 63 years, 60% were men, and the vast majority of patients had an advanced bilio-pancreatic tumor (85%). With a median follow-up of 18 months, median OS was 6 months (95% CI: 1-11); and OS probability at 18-month was 19%. MHS was 27.2 days (95% CI: 20.3-40.7). Risk factors for developing liver abscesses were: a) bilio-pancreatic cancers; b) chemotherapy administration; c) severe malnutrition; and d) biliary drainage/prosthesis. Ten patients (50%) had bacteremia, and the most common isolated microorganism was E.coli (30%). Percutaneous drainage of abscesses was performed in 40% of the patients, and all patients were treated with broad-spectrum antibiotics.

Conclusions: Although liver abscesses were uncommon, they were associated with a prolonged hospitalization and poor outcome in cancer patients.

References

Lee K-T, Wong S-R, Sheen P-C. Pyogenic Liver Abscess: An Audit of 10 Years’ Experience and Analysis of Risk Factors. Digestive Surgery 2001; 18(6): 459-65. https://doi.org/10.1159/000050194 DOI: https://doi.org/10.1159/000050194

Yuping LD, Lamano JB, Lamano JB, Quaggin-Smith J, Veliceasa D, Kaur G, Biyashev D, Unruh D, Bloch O. Tumor-Induced Peripheral Immunosuppression Promotes Brain Metastasis in Patients with Non-Small Cell Lung Cancer. Cancer Immunology, Immunotherapy 2019; 68(9): 1501-13. https://doi.org/10.1007/s00262-019-02384-y DOI: https://doi.org/10.1007/s00262-019-02384-y

Krish P, West H. Febrile Neutropenia. JAMA Oncology 2017; 3(12): 1751. https://doi.org/10.1001/jamaoncol.2017.1114 DOI: https://doi.org/10.1001/jamaoncol.2017.1114

Bob P, Morgan JE, Haeusler GM, Riley RD. Individual Participant Data Validation of the PICNICC Prediction Model for Febrile Neutropenia. Archives of Disease in Childhood 2019; pii: archdischild-2019-317308. https://doi.org/10.1136/archdischild-2019-317308 DOI: https://doi.org/10.1136/archdischild-2019-317308

Kai Q, Liu C, Wang Z-X, Tian F, Wei J-C, Tai M-H, Zhou L, Meng F-D, Wang R-T, Xu X-S. Pyogenic Liver Abscesses Associated with Nonmetastatic Colorectal Cancers: An Increasing Problem in Eastern Asia. World Journal of Gastroenterology 2012; 18(23): 2948-55. https://doi.org/10.3748/wjg.v18.i23.2948 DOI: https://doi.org/10.3748/wjg.v18.i23.2948

Mohan BP, Aravamudanb VM, Khana SR, Chandanc S, Ponnadad S, Asokkumare R, Navaneethanf U, Adler DG. Prevalence of Colorectal Cancer in Cryptogenic Pyogenic Liver Abscess Patients. Do They Need Screening Colonoscopy? A Systematic Review and Meta-analysis. Digestive and Live Disease 2019; 51(12): 1641-45. https://doi.org/10.1016/j.dld.2019.08.016 DOI: https://doi.org/10.1016/j.dld.2019.08.016

Zhongzhi J, Tu J, Cao C, Wang W, Zhou W, Ji J, Li M. Liver Abscess Following Transarterial Chemoembolization for the Treatment of Hepatocellular Carcinoma: A Retrospective Analysis of 23 Cases. Journal of Cancer Research and Therapeutics 2018; 14(Suppl): S628-S633. https://doi.org/10.4103/0973-1482.199385 DOI: https://doi.org/10.4103/0973-1482.199385

Kelvin C, Guo H, Cheng S, Beca JM, Redmond‐Misner R, Isaranuwatchai W, Qiao L, Earle C, Berry SR, Biagi JJ, Welch S, Meyers BM, Mittmann N, Coburn N, Arias J, Schwartz D, Dai WF, Gavura S, McLeod R, Kennedy ED. Real-World Outcomes of FOLFIRINOX vs Gemcitabine and Nab-Paclitaxel in Advanced Pancreatic Cancer: A Population-Based Propensity Score-Weighted Analysis. Cancer Medicine 2020; 9(1): 160-9. https://doi.org/10.1002/cam4.2705 DOI: https://doi.org/10.1002/cam4.2705

Thierry C, Desseigne F, Ychou M, Bouché O, Guimbaud R, Bécouarn Y, Adenis A, Raoul J-L, Gourgou-Bourgade S, de la Fouchardière C, Bennouna J, Bachet J-B. FOLFIRINOX versus Gemcitabine for Metastatic Pancreatic Cancer. The New England Journal of Medicine 2011; 364(19): 1817-25. https://doi.org/10.1056/NEJMoa1011923 DOI: https://doi.org/10.1056/NEJMoa1011923

Juan V, Wasan H, Palmer DH, Cunningham D, Anthoney A, Maraveyas A, Madhusudan S, Iveson T, Hughes S, Pereira SP, Roughton M, Bridgewater J. Cisplatin plus Gemcitabine versus Gemcitabine for Biliary Tract Cancer. The New England Journal of Medicine 2010; 362(14): 1273-81. https://doi.org/10.1056/NEJMoa0908721 DOI: https://doi.org/10.1056/NEJMoa0908721

Audrey L, Thissen J-P. Biomarkers of Cancer Cachexia. Clinical Biochemistry 2017; 50(18): 1281-88. https://doi.org/10.1016/j.clinbiochem.2017.07.011 DOI: https://doi.org/10.1016/j.clinbiochem.2017.07.011

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Published

2019-03-06

How to Cite

Khosravi-Shahi Parham, Aparicio-Salcedo María Inmaculada, Alva-Bianchi Manuel, Arregui-Valles Marta, Morón-García Blanca Isabel, Tirado-Anula Victoria Clara, De Toro-Carmena María, Martínez-Delfrade Iñigo, & González-del-Val Ricardo. (2019). Liver Abscesses in Cancer Patients Associated with Poor Prognosis: A Single Center Experience . Journal of Cancer Research Updates, 8(1), 52–55. https://doi.org/10.30683/1929-2279.2019.08.07

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