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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3.	Llovet JM, Schwartz M, Mazzaferro V. Resection and liver transplantation for hepatocellular carcinoma [J]. Semin Liver Dis, 2005, 25(2): 181200.
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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.
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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.	孫惠川, 湯敏, 欽倫秀, 等. 用余肝體積預測半肝切除耐受性的安全標準 [J]. 中華肝膽外科雜志, 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, 張陽德, 伍保忠, 等. CT肝硬化定量診斷的應用研究 [J]. 臨床肝膽病雜志, 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.	何強, 梁力建, 彭寶崗, 等. 大肝癌手術切除的風險性分析 [J]. 中華普通外科雜志, 2004, 19(4): 197199.
17.	嚴律南, 陳曉理, 李志輝, 等. 肝癌肝切除術圍手術期處理的臨床研究(附2 143例報告) [J]. 中國普外基礎與臨床雜志, 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. 孫惠川, 湯敏, 欽倫秀, 等. 用余肝體積預測半肝切除耐受性的安全標準 [J]. 中華肝膽外科雜志, 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, 張陽德, 伍保忠, 等. CT肝硬化定量診斷的應用研究 [J]. 臨床肝膽病雜志, 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. 何強, 梁力建, 彭寶崗, 等. 大肝癌手術切除的風險性分析 [J]. 中華普通外科雜志, 2004, 19(4): 197199.
17. 嚴律南, 陳曉理, 李志輝, 等. 肝癌肝切除術圍手術期處理的臨床研究(附2 143例報告) [J]. 中國普外基礎與臨床雜志, 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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