Surgical Strategy Based on Indocyanine Green Test for Chemotherapy-Associated Liver Injury and Long-Term Outcome in Colorectal Liver Metastases

Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract
Takeshi TakamotoMasatoshi Makuuchi

Abstract

It remains unclear whether the presence of chemotherapy-induced liver injury (CALI) or impaired liver functional reserve affects the long-term outcome. This study assessed the applicability and long-term effects of using criteria based on the indocyanine green (ICG) test results in selecting the operative procedure among patients with colorectal liver metastases (CRLM) who had a risk of CALI. CRLM patients who received preoperative chemotherapy including oxaliplatin and/or irinotecan prior to a curative hepatectomy between 2007 and 2017 were included. For each case, the minimum required future remnant liver volume and operative procedure were decided based on the ICG retention rate at 15 min (ICG R15). Patients with an ICG R15 > 10% and who had undergone a major hepatectomy were categorized in a marginal liver functional reserve (MHML) group. Overall, 161 patients were included; 77 of them had an ICG R15 > 10%, and 57 had pathological liver injury (PLI). After the median follow-up time of 30.9 months, the 5-year overall survival rate was 36.1%. The presence of an impaired ICG test result or CALI did not negatively impact the overall and recurrence-free survival outcomes. A multivariate analysis revealed that the presence of fou...Continue Reading

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Citations

Feb 27, 2019·Journal of Surgical Oncology·Rachel M LeeMaria C Russell
Jul 8, 2018·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Takeshi TakamotoMasatoshi Makuuchi
Dec 5, 2018·World Journal of Clinical Cases·Feng XuChao-Liu Dai
Mar 4, 2021·Journal of Surgical Oncology·Takaaki KonishiMasatoshi Makuuchi
May 1, 2021·Annals of Surgical Oncology·Luca ViganoGuido Torzilli

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