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

Russolillo, Nadia; Langella, Serena; Perotti, Serena; Tesoriere, Roberto Lo; Forchino, Fabio; Ferrero, Alessandro

doi:10.1016/j.ijsu.2016.05.065

Cited by 8 publications

(3 citation statements)

References 40 publications

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“…Indeed, radiologic studies do not provide satisfactory information 42. Furthermore, proposed methods for identifying patients with CALI, such as ICG clearance,43 , 44 are expensive and have not found their way into clinical routine. Thus, liver biopsy often is the examination of choice, but due to the high degree of invasiveness, it is reserved for high-risk patients with suspicion of severe liver damage.…”

Section: Discussionmentioning

confidence: 99%

The Combination of APRI and ALBI Facilitates Preoperative Risk Stratification for Patients Undergoing Liver Surgery After Neoadjuvant Chemotherapy

et al. 2019

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Background Neoadjuvant chemotherapy (NeoCTx) is performed for most patients with colorectal cancer liver metastases (CRCLM). However, chemotherapy-associated liver injury (CALI) has been associated with poor postoperative outcome. To date, however, no clinically applicable and noninvasive tool exists to assess CALI before liver resection. Methods Routine blood parameters were assessed in 339 patients before and after completion of NeoCTx and before surgery. The study assessed the prognostic potential of the aspartate aminotransferase (AST)-to-platelet ratio index (APRI), the albumin-bilirubin grade (ALBI), and their combinations. Furthermore, an independent multi-center validation cohort ( n = 161) was included to confirm the findings concerning the prediction of postoperative outcome. Results Higher ALBI, APRI, and APRI + ALBI were found in patients with postoperative morbidity ( P = 0.001, P = 0.064, P = 0.001, respectively), liver dysfunction (LD) ( P = 0.009, P = 0.012, P < 0.001), or mortality ( P = 0.037, P = 0.045, P = 0.016), and APRI + ALBI had the highest predictive potential for LD (area under the curve [AUC], 0.695). An increase in APRI + ALBI was observed during NeoCTx ( P < 0.001). Patients with longer periods between NeoCTx and surgery showed a greater decrease in APRI + ALBI ( P = 0.006) and a trend for decreased CALI at surgery. A cutoff for APRI + ALBI at − 2.46 before surgery was found to identify patients with CALI ( P = 0.002) and patients at risk for a prolonged hospital stay ( P = 0.001), intensive care ( P < 0.001), morbidity ( P < 0.001), LD ( P < 0.001), and mortality ( P = 0.021). Importantly, the study was able to confirm the predictive potential of APRI + ALBI for postoperative LD and mortality in a multicenter validation cohort. Conclusion Determination of APRI + ALBI before surgery enables identification of high-risk patients for liver resection. The combined score seems to dynamically reflect CALI. Thus, APRI + ALBI could be a clinically relevant tool for optimizing timing of surgery in CRCLM patients after NeoCTx. Electronic supplementary material The online version of this article (10.1245/s10434-018-07125-6) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

The Combination of APRI and ALBI Facilitates Preoperative Risk Stratification for Patients Undergoing Liver Surgery After Neoadjuvant Chemotherapy

et al. 2019

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“…A correlation between ICGR15 values and SOS has been described [ 17 , 18 ]. The cut-off point of the ICGR15 test that correlated with diagnosis of SOS was 8% [ 19 ]. Although the background of liver tissue was mild SOS pathologically, the ICG R15 value was extremely high.…”

Section: Discussionmentioning

confidence: 99%

Hepatectomy in a case of hepatocellular carcinoma with constitutional indocyanine green excretory defect

Nakatake

Ishizaki

Miyasaka

et al. 2018

International Journal of Surgery Case Reports

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HighlightsConstitutional indocyanine green excretory defect is extremely rare.The ICGR15 is important for estimating hepatic functional reserve and selection of the appropriate surgical procedure.Because of the rarity of constitutional ICG excretory defect, its clinical features are not well understood.At present, the indications for surgery for this condition should be comprehensively considered.Findings of liver function tests, such as a general liver function test and GSA liver scintigraphy, are important for treating this disorder.

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“…[7][8][9][10] LI also decreased hepatic functional reserve and aggravated the postoperative course of colorectal cancer patients after hepatectomy, and may affect intraoperative bleeding, postoperative morbidity, and overall survival. 9,11,12 LI can further progress to liver fibrosis and liver cirrhosis, both of which would be detrimental to the patients' health. 13 The risk of OXA-induced LI (OILI) can be greatly reduced if people potentially at high risk of OILI can be identified and then treated and prevented accordingly in advance.…”

Section: Introductionmentioning

confidence: 99%

Predictive Model of Oxaliplatin-induced Liver Injury Based on Artificial Neural Network and Logistic Regression

Huang,

Cai,

et al. 2023

J Clin Transl Hepatol

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Background and Aims Identifying potential high-risk groups of oxaliplatin-induced liver injury (OILI) is valuable, but tools are lacking. So artificial neural network (ANN) and logistic regression (LR) models will be developed to predict the risk of OILI. Methods The medical information of patients treated with oxaliplatin between May and November 2016 at 10 hospitals was collected prospectively. We used the updated Roussel Uclaf causality assessment method (RUCAM) to identify cases of OILI and summarized the patient and medication characteristics. Furthermore, the ANN and LR models for predicting the risk of OILI were developed and evaluated. Results The incidence of OILI was 3.65%. The median RUCAM score with interquartile range was 6 (4, 9). The ANN model performed similarly to the LR model in sensitivity, specificity, and accuracy. In discrimination, the area under the curve of the ANN model was larger (0.920>0.833, p =0.019). In calibration, the ANN model was slightly improved. The important predictors of both models overlapped partially, including age, chemotherapy regimens and cycles, single and total dose of OXA, glucocorticoid drugs, and antihistamine drugs. Conclusions When the discriminative and calibration ability was given priority, the ANN model outperformed the LR model in predicting the risk of OILI. Other chemotherapy drugs in oxaliplatin-based chemotherapy regimens could have different degrees of impact on OILI. We suspected that OILI may be idiosyncratic, and chemotherapy dose factors may be weakly correlated. Decision making on prophylactic medications needs to be carefully considered, and the actual preventive effect needed to be supported by more evidence.

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

Abstract: ICGR15 test can predict the diagnosis of SOS. High ICGR15 value is more common in elderly male patients and after bevacizumab administration.

Cited by 8 publications

References 40 publications

The Combination of APRI and ALBI Facilitates Preoperative Risk Stratification for Patients Undergoing Liver Surgery After Neoadjuvant Chemotherapy

The Combination of APRI and ALBI Facilitates Preoperative Risk Stratification for Patients Undergoing Liver Surgery After Neoadjuvant Chemotherapy

Hepatectomy in a case of hepatocellular carcinoma with constitutional indocyanine green excretory defect

Predictive Model of Oxaliplatin-induced Liver Injury Based on Artificial Neural Network and Logistic Regression

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