caa a22 4500 445333588 CHVBK 20180317142745.0 cr unu---uuuuu 170323e20110601xx s 000 0 eng 10.1245/s10434-010-1494-1 doi (NATIONALLICENCE)springer-10.1245/s10434-010-1494-1 Evaluation of Chemotherapy-Associated Liver Injury in Patients with Colorectal Cancer Liver Metastases Using Indocyanine Green Clearance Testing [Elektronische Daten] [Peter-Michael Krieger, Dietmar Tamandl, Beata Herberger, Peter Faybik, Edith Fleischmann, Judith Maresch, Thomas Gruenberger] Background: Systemic chemotherapy may render initially unresectable colorectal cancer liver metastases resectable. Histopathologic examinations of resected nontumoral liver tissue revealed chemotherapy-associated liver injuries, which was recognized to impair the function of the remnant liver. We therefore evaluated whether indocyanine green (ICG) plasma clearance helps to assess chemotherapy-induced liver damage. Methods: Data of 101 liver resections performed between 2006 and 2008 for colorectal liver metastases were analyzed for this study. Eighteen patients had liver resection without preoperative treatment, whereas 83 patients underwent neoadjuvant chemotherapy before surgery. ICG clearance was assessed by pulse densitometry before surgery. Results: Comparison of ICG retention clearances demonstrated that patients pretreated with systemic chemotherapy had a significantly lower plasma disappearance rate (ICG-PDR; 19.3±5.9 vs. 23.1±3.8%/min; P=0.002) and a significantly elevated ICG retention rate at 15min (7.9±6.6 vs. 3.8±1.9%; P<0.001). The percentage of subjects with an abnormal ICG-PDR (≤18%/min) was significantly higher in the pretreated group (48.2% vs. 5.6%; P=0.001). Patients with an ICG-PDR of ≤18 had a prolonged postoperative hospital stay and experienced four times more complications in their postoperative course. Conclusions: ICG clearance helps to identify patients with impaired liver function after neoadjuvant chemotherapy and aids in the estimation of the postoperative risk of morbidity after liver resection for colorectal liver metastases. Society of Surgical Oncology, 2010 Krieger Peter-Michael Department of General Surgery, Medical University of Vienna, Vienna, Austria aut Tamandl Dietmar Department of General Surgery, Medical University of Vienna, Vienna, Austria aut Herberger Beata Department of General Surgery, Medical University of Vienna, Vienna, Austria aut Faybik Peter Department of Anaesthesiology, Medical University of Vienna, Vienna, Austria aut Fleischmann Edith Department of Anaesthesiology, Medical University of Vienna, Vienna, Austria aut Maresch Judith Department of Pathology, Medical University of Vienna, Vienna, Austria aut Gruenberger Thomas Department of General Surgery, Medical University of Vienna, Vienna, Austria aut Annals of Surgical Oncology Springer-Verlag 18/6(2011-06-01), 1644-1650 1068-9265 18:6<1644 2011 18 10434 https://doi.org/10.1245/s10434-010-1494-1 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-010-1494-1 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Krieger Peter-Michael Department of General Surgery, Medical University of Vienna, Vienna, Austria aut NATIONALLICENCE 700 1- Tamandl Dietmar Department of General Surgery, Medical University of Vienna, Vienna, Austria aut NATIONALLICENCE 700 1- Herberger Beata Department of General Surgery, Medical University of Vienna, Vienna, Austria aut NATIONALLICENCE 700 1- Faybik Peter Department of Anaesthesiology, Medical University of Vienna, Vienna, Austria aut NATIONALLICENCE 700 1- Fleischmann Edith Department of Anaesthesiology, Medical University of Vienna, Vienna, Austria aut NATIONALLICENCE 700 1- Maresch Judith Department of Pathology, Medical University of Vienna, Vienna, Austria aut NATIONALLICENCE 700 1- Gruenberger Thomas Department of General Surgery, Medical University of Vienna, Vienna, Austria aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/6(2011-06-01), 1644-1650 1068-9265 18:6<1644 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer