Preoperative assessment of chemotherapeutic associated liver injury based on indocyanine green retention test

•ICG test can predict the diagnosis of SOS but does not give any information on nodular regenerative hyperplasia and steatohepatitis.•High preoperative ICGR15 values are more common in elderly male patients and after bevacizumab administration.•High preoperative ICGR15 values not represent a contraindication to liver surgery.

BackgroundThe aim of the study was to assess the capacity of indocyanine green retention test at 15 min (ICGR15) to predict chemotherapeutic-associated liver injuries (CALI).MethodsPatients undergoing liver resection for CLM that received preoperative oxaliplatin and/or irintecan-based chemotherapy within 3 months before surgery and scheduled first hepatectomy were considered.Results166 out of 983 patients treated between 01/2001 and 04/2014 fulfilled the inclusion criteria. The median number of cycles of preoperative chemotherapy was 6.0 ± 4.87. Chemotherapy was mainly based on oxaliplatin in 123 (74.1%). Bevacizumab was associated in 51(31%) patients. A total of 102 (61.4%) patients had at least 1 CALI. Grade 2–3 steatosis occurred in 56 (33.7%) patients and steatohepatitis in19(11.5%). Sinusoidal obstructive syndrome (SOS) was presented in 93 (56%) patients. 23(13.8%) patients had nodular regeneration hyperplasia. At multivariate analysis the only predictive factor of ICGR≥10% was age≥65 years (p = 0.001). A median split (ICGR15 = 8%) was used to categorized ICGR15 value. Multivariate analysis showed that age≥ 65 [OR 2.530 (CI95% 1.28–4.97) p < 0.001], male sex [OR 2.614 (CI95% 1.31–5.20) p < 0.001], SOS [OR 1.954 (CI95% 1.00–3.81) p = 0.050] and administration of Bevacizumab [OR 2.201 (CI95% 1.07–4.50) p = 0.031] were predictive factors for ICGR≥8%.ConclusionsICGR15 test can predict the diagnosis of SOS. High ICGR15 value is more common in elderly male patients and after bevacizumab administration.