Perioperative and Recurrence-Free Survival Outcomes after Laparoscopic Hepatectomy for Colorectal Cancer Liver Metastases Using Indocyanine Green Fluorescence Imaging: A Single-Center Experience

Abstract Background Indocyanine green (ICG) fluorescence imaging has been extensively used in the context of laparoscopic hepatectomy for colorectal cancer liver metastases (CRLM). Nevertheless, there remains a lack of strong evidence on the influence of perioperative and survival outcomes in patients undergoing such procedure. Methods The retrospective cohort study was conducted on consecutive patients with CRLM who underwent laparoscopic hepatectomy. The patients were divided into two groups based on utilization of ICG fluorescence imaging during surgical procedure. Data on sociodemographic characteristics, laboratory parameters, pathology findings, surgical outcomes, and survival results were systematically collected for analysis. Results A total of 117 patients were involved in the analysis. Compared to the traditional groups, the ICG-guided group had a significantly higher rate of negative margin (97% v.s 86%, p = 0.009) and lower rate of postoperative bile leakage (13% v.s 31%, p = 0.018). ICG fluorescence imaging was determined to be an independent risk factor associated with postoperative bile leakage ( OR = 0.035, 95%CI 0.114–0.982, p = 0.046). As of the last recorded follow-up date, there were 82 (76.6%) recurrences in the entire cohort. No significant difference was found between the two groups in terms of early recurrence rate (26.3% v.s 40%, p = 0.132). However, the intrahepatic recurrence rate was significantly lower in the ICG-guided group (45.6% v.s 68.0%, p = 0.02). The median recurrence free survival of patients in the ICG-guided group was significantly longer compared to the traditional group (11.3 v.s 7.2 months, p = 0.041). Conclusion ICG fluorescence imaging can be utilized to delineate tumor boundaries and determine surgical margin during surgical procedures for CRLM. Additionally, it has shown promising potential in improving the perioperative and recurrence-free survival outcomes in these patients.