Precision in liver surgery: A comparative analysis of volumetry techniques Journal Article

  


Authors: Choubey, A. P.; Chou, J.; Ilagan, C.; Steinharter, J.; Heiselman, J. S.; Chakraborty, J.; Soares, K. C.; Wei, A. C.; Gonen, M.; Balachandran, V. P.; Drebin, J.; Kingham, T. P.; D’Angelica, M. I.; Jarnagin, W. R.
Article Title: Precision in liver surgery: A comparative analysis of volumetry techniques
Abstract: Background: Future liver remnant volume (FLRV) is a critical determinant of safety for hepatectomy. This study assesses concordance between imaging-based measured FLRV (mFLRV), and body surface area (BSA)-based standardized FLRV (sFLRV), and their association with post-hepatectomy complications. Materials and Methods: All major hepatectomy between 1999 and 2021 were assessed for agreement between mFLRV and sFLRV using concordance correlation coefficient (CCC). Association between each method and major postoperative complications, post-hepatectomy liver failure (PHLF), or grade 4/5 morbidity was compared using logistic regression model and area under the receiver-operating characteristic (AUC) curve to evaluate the discriminatory power of each volumetry method separately. Results: A total of 1749 patients were included, 49% were female, median age was 60 years, 70.2% had metastatic disease, and 49.7% received preoperative chemotherapy. Median sFLRV (41.3%) was higher than mFLRV (39.4%). Major complications were observed in 5.1% (n = 90). Concordance between mFLRV and sFLRV was moderate, CCC = 0.78 (95% CI 0.75–0.79) but was poor (CCC = 0.39; 95% CI 0.32–0.43) among patients with mFLRV ≤ 35% (n = 528). In this subset, sFLRV overestimated remnant volume in 63% (n = 333) with ≥ 5% overprediction in 145 patients (27.5%). Factors associated with ≥ 5% variation were lower weight (p = 0.003), lower BMI (p = 0.003), and lower BSA (p = 0.004). Both methods performed similarly in predicting major complications with AUC of 0.64 and 0.63 for sFLRV and mFLRV, respectively. Conclusions: Imaging- and BSA-based volumetry are moderately correlated, with poor concordance among patients with smaller FLRV where sFLRV overestimated remnant volume. Both techniques can be safely used for volumetric assessment before major hepatectomy. © Society of Surgical Oncology 2025.
Keywords: hepatectomy; volumetry; body surface area; future liver remnant
Journal Title: Annals of Surgical Oncology
Volume: 32
ISSN: 1068-9265
Publisher: Springer  
Publication status: Published
Date Published: 2025-09-01
Start Page: 6254
End Page: 6262
Language: English
DOI: 10.1245/s10434-025-17462-y
PUBMED: 40402422
PROVIDER: scopus
DOI/URL:

https://www.scopus.com/inward/record.uri?eid=2-s2.0-105006520352&doi=10.1245%2fs10434-025-17462-y&partnerID=40&md5=3dd656cbf34b513d8329e4b55bdf5ac5
Notes: Source: Scopus
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MSK Authors
  1. Joanne Fu-Lou Chou
    338 Chou
  2. Mithat Gonen
    1036 Gonen
  3. William R Jarnagin
    913 Jarnagin
  4. Michael D'Angelica
    789 D'Angelica
  5. T Peter Kingham
    622 Kingham
  6. Vinod P Balachandran
    257 Balachandran
  7. Jayasree Chakraborty
    70 Chakraborty
  8. Jeffrey Adam Drebin
    170 Drebin
  9. Alice Chia-Chi Wei
    210 Wei
  10. Kevin Cerqueira Soares
    145 Soares
  11. Crisanta Hipolito Ilagan
    6 Ilagan
  12. Jon Stanley Heiselman
    25 Heiselman
  13. Ankur Pranjal Choubey
    11 Choubey
  14. John Jack Steinharter
    1 Steinharter
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