Role of Spleen/Remnant Liver Volume Ratio in Surgical Treatment for Liver Cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

JIANG Ou , LIU Yu , WU Wenjian , WU Daoquan , XU Qiang.

Cancer Centre, The Second People’s Hospital of Neijiang, Neijiang 641000, Sichuan Province, China;

Corresponding author：

Keywords：

Primary liver cancer; Operation; Spleen/liver volume ratio; Cirrhosis

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ObjectiveTo study the clinical role of spleen/remnant liver volume ratio in evaluating liver reserve function after surgical treatment for liver cancer. MethodsTo calculate the ratio of spleen volume/remnant liver volume after tumor excision with imaging method and immersion method; to analyze the relationships between spleen/remnant liver volume ratio and liver function score after operation as well as hospital stay. ResultsLiver function ChildPugh score was related mainly with spleen/remnant liver volume ratio (t=7.831, P=0.000), which was proved by multiple regression analysis. The median hospital stay of the group with spleen/remnant liver ratio ≤0.9 was 14 d （12-16 d）, which was less than that (22 d, 15-29 d) of the other group with the ratio gt;0.9 (P=0.000). ConclusionsSpleen/remnant liver volume ratio can predict effectively recovery ability of patients after operation for liver cancer， and assess correctly the reserve function of liver. When the ratio is less than or equal 0.9, the operation is safe.

Citation： JIANG Ou,LIU Yu,WU Wenjian,WU Daoquan,XU Qiang.. Role of Spleen/Remnant Liver Volume Ratio in Surgical Treatment for Liver Cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2011, 18(5): 528-532. doi: Copy

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8.	Shirabe K, Shimada M, Gion T, et al. Postoperative liver failure after major hepatic resection for hepatocellular carcinoma in the modern era with special reference to remnant liver volume [J]. J Am Coll Surg, 1999, 188(3): 304309.
9.	孙惠川, 汤敏, 钦伦秀, 等. 用余肝体积预测半肝切除耐受性的安全标准 [J]. 中华肝胆外科杂志, 2006, 12(6)： 366369.
10.	Groshar D, Slobodin G, Zuckerman E. Quantitation of liver and spleen uptake of (99m)Tcphytate colloid using SPECT: detection of liver cirrhosis [J]. J Nucl Med, 2002, 43(3): 312317.
11.	Zhang XJ, Kanematsu M, Kato H, et al. Differentiation of cirrhosis by using 3D hepatic volume ratio of LTW in multidetector row CT scans and MR imaging [J]. International Congress Series, 2005, 1281： 11631168.
12.	Yamaguchi S, Kawanaka H, Yoshida D, et al. Splenic hemodynamics and decreased endothelial nitric oxide synthase in the spleen of rats with liver cirrhosis [J]. Life Sci, 2007, 80(22): 20362044.
13.	Hoefs JC, Wang FW, Lilien DL, et al. A novel, simple method of functional spleen volume calculation by liverspleen scan [J]. J Nucl Med, 1999, 40(10): 17451755.
14.	涂蓉, 张阳德, 伍保忠, 等. CT肝硬化定量诊断的应用研究 [J]. 临床肝胆病杂志, 2004, 20(1)： 2829.
15.	Vauthey JN, Chaoui A, Do KA, et al. Standardized measurement of the future liver remnant prior to extended liver resection: methodology and clinical associations [J]. Surgery, 2000, 127(5): 512519.
16.	何强, 梁力建, 彭宝岗, 等. 大肝癌手术切除的风险性分析 [J]. 中华普通外科杂志, 2004, 19(4): 197199.
17.	严律南, 陈晓理, 李志辉, 等. 肝癌肝切除术围手术期处理的临床研究(附2 143例报告) [J]. 中国普外基础与临床杂志, 2005, 12(2): 162166.

1. Heymsfield SB, Fulenwider T, Nordlinger B, et al. Accurate measurement of liver, kidney, and spleen volume and mass by computerized axial tomography [J]. Ann Intern Med, 1979, 90(2): 185187.
2. Urata K, Kawasaki S, Matsunami H, et al. Calculation of child and adult standard liver volume for liver transplantation [J]. Hepatology, 1995, 21(5): 13171321.
3. Llovet JM, Schwartz M, Mazzaferro V. Resection and liver transplantation for hepatocellular carcinoma [J]. Semin Liver Dis, 2005, 25(2): 181200.
4. Schneider PD. Preoperative assessment of liver function [J]. Surg Clin North Am, 2004, 84(2): 355373.
5. Faybik P, Krenn CG, Baker A, et al. Comparison of invasive and noninvasive measurement of plasma disappearance rate of indocyanine green in patients undergoing liver transplantation: a prospective investigatorblinded study [J]. Liver Transpl, 2004, 10(8): 10601064.
6. Ohwada S, Kawate S, Hamada K, et al. Perioperative realtime monitoring of indocyanine green clearance by pulse spectrophotometry predicts remnant liver functional reserve in resection of hepatocellular carcinoma [J]. Br J Surg, 2006, 93(3): 339346.
7. Ogasawara K, Une Y, Nakajima Y, et al. The significance of measuring liver volume using computed tomographic images before and after hepatectomy [J]. Surg Today, 1995, 25(1): 4348.
8. Shirabe K, Shimada M, Gion T, et al. Postoperative liver failure after major hepatic resection for hepatocellular carcinoma in the modern era with special reference to remnant liver volume [J]. J Am Coll Surg, 1999, 188(3): 304309.
9. 孙惠川, 汤敏, 钦伦秀, 等. 用余肝体积预测半肝切除耐受性的安全标准 [J]. 中华肝胆外科杂志, 2006, 12(6)： 366369.
10. Groshar D, Slobodin G, Zuckerman E. Quantitation of liver and spleen uptake of (99m)Tcphytate colloid using SPECT: detection of liver cirrhosis [J]. J Nucl Med, 2002, 43(3): 312317.
11. Zhang XJ, Kanematsu M, Kato H, et al. Differentiation of cirrhosis by using 3D hepatic volume ratio of LTW in multidetector row CT scans and MR imaging [J]. International Congress Series, 2005, 1281： 11631168.
12. Yamaguchi S, Kawanaka H, Yoshida D, et al. Splenic hemodynamics and decreased endothelial nitric oxide synthase in the spleen of rats with liver cirrhosis [J]. Life Sci, 2007, 80(22): 20362044.
13. Hoefs JC, Wang FW, Lilien DL, et al. A novel, simple method of functional spleen volume calculation by liverspleen scan [J]. J Nucl Med, 1999, 40(10): 17451755.
14. 涂蓉, 张阳德, 伍保忠, 等. CT肝硬化定量诊断的应用研究 [J]. 临床肝胆病杂志, 2004, 20(1)： 2829.
15. Vauthey JN, Chaoui A, Do KA, et al. Standardized measurement of the future liver remnant prior to extended liver resection: methodology and clinical associations [J]. Surgery, 2000, 127(5): 512519.
16. 何强, 梁力建, 彭宝岗, 等. 大肝癌手术切除的风险性分析 [J]. 中华普通外科杂志, 2004, 19(4): 197199.
17. 严律南, 陈晓理, 李志辉, 等. 肝癌肝切除术围手术期处理的临床研究(附2 143例报告) [J]. 中国普外基础与临床杂志, 2005, 12(2): 162166.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Role of Spleen/Remnant Liver Volume Ratio in Surgical Treatment for Liver Cancer

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