There is no way of predicting who among our early breast cancer patients develop liver injury during neoadjuvant treatment. It is our aim to determine such event by determining Computed tomography liver spleen ratio (LS ratio) and comparing it to liver function test.
Retrospective review in the Philippines for Stage I-III invasive breast cancer. Computed tomography LS ratio was reviewed by one radiologist. LS ratio cut off values were tested of their accuracy in terms of sensitivity, specificity, negative, and positive predictive values wherein a computed AUC of > 0.70 is considered significantly valid predictive markers.
Total of 35 patients with average age of 53.91 years old, 57% had stage IIIB cancer. Patients’ average liver spleen ratio was 1.10±0.30 at the start, then, it slightly increased towards the end of the treatment (1.13±0.32). SGPT (37.43 to 35.09, p = 0.479) changed from start to end of treatment. Higher rates of liver injury at the start of treatment were as follows, 1(100%) with DOCETAXEL-TRASTUZUMAB, FAC (1,100%), and TAC (1, 11.1%). End of treatment, liver injury were noted among those with AC (1,50%), FAC (1,100%), EPIRUBICIN, DOCETAXEL (1,25%), and TAC (1,11.1%). Liver spleen ratio is significantly correlated with SGPT (r= -0.541, p = 0.001). At end of treatment, LS ratio is correlated with SGPT (r = -0.464, p = 0.005). LS ratio has higher sensitivity at start of treatment 100% at cut off 0.52, while at end of treatment the cut off was 0.87 has higher sensitivity (100%) in predicting liver injury. Based on AUC, LS ratio at the end of treatment showed higher accuracy (AUC =0.597) indicating the LS ratio can be utilized as marker for predicting liver injury.
Higher rates of liver injury at the start of treatment were seen those given Docetaxel- Trastuzumab, FAC and TAC. No liver injury for patients with hormonal treatment. End of treatment, liver injury seen in receiving anthracycline- based regimen. Liver spleen ratio is significantly correlated with SGPT. LS ratio at the end of treatment showed higher accuracy indicating the LS ratio be utilized as marker for predicting liver injury.
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All authors have declared no conflicts of interest.