Copyright
©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
Scoring criteria for determining the safety of liver resection for malignant liver tumors
Kohei Harada, Minoru Nagayama, Yoshiya Ohashi, Ayaka Chiba, Kanako Numasawa, Makoto Meguro, Yasutoshi Kimura, Hiroshi Yamaguchi, Masahiro Kobayashi, Koji Miyanishi, Junji Kato, Toru Mizuguchi
Kohei Harada, Minoru Nagayama, Makoto Meguro, Yasutoshi Kimura, Hiroshi Yamaguchi, Toru Mizuguchi, Departments of Surgery, Surgical Science, and Oncology, Sapporo Medical University, Sapporo, Hokkaido 060-8556, Japan
Kohei Harada, Yoshiya Ohashi, Ayaka Chiba, Kanako Numasawa, Division of Radiology, Sapporo Medical University Hospital, Sapporo, Hokkaido 060-8556, Japan
Kohei Harada, Toru Mizuguchi, Sapporo Medical University Postgraduate School of Health Science and Medicine, Sapporo Medical University, Sapporo, Hokkaido 060-8556, Japan
Masahiro Kobayashi, Research and Education Center for Clinical Pharmacy, Kitasato University School of Pharmacy, Tokyo 108-8641, Japan
Koji Miyanishi, Junji Kato, Department of Internal Medicine IV, Sapporo Medical University, Sapporo, Hokkaido 060-8556, Japan
Toru Mizuguchi, Department of Nursing and Surgical Science, Sapporo Medical University, Sapporo 0608543, Japan
Author contributions: Harada K and Miyanishi K conceptualized and designed the systematic review; Ohashi Y, Chiba A, and Numasawa K collected data from the radiological database; Nagayama M and Meguro M searched for and screened the articles; Kimura Y, Yamaguchi H, and Kobayashi M assessed the articles for eligibility; Harada K and Yamaguchi H carried out the statistical analyses; Kato J supervised and audited the preparation of the manuscript; Harada K and Mizuguchi T drafted the initial manuscript; and Mizuguchi T finalized the manuscript. All of the authors reviewed and approved the final manuscript as submitted.
Supported by a Grant-in-Aid for Scientific Research from the Ministry of Education, Culture, Sports, Science, and Technology, Japan, No. 23591993 to TM, and No. 24791437 to MM, No. 17K10672; to T Mizuguchi. Part of this study was also supported by Astellas Pharma, Inc., No. RS2018A000763, Tokyo, Japan; Daiichi Sankyo Company, No. 1800461, Tokyo, Japan; Shionogi & Co., No. RS2018A000439931, Osaka, Japan; Merk Serono, No. MSJS20180613001, Tokyo, Japan; Sapporo Doto Hospital, No. 30037656, Sapporo, Japan; Noguchi Hospital, No. 30047663, Otaru, Japan; Doki-kai Tomakomai Hospital, No. 30047674, Tomakomai, Japan; Tsuchida Hospital, No. 30057704, Sapporo, Japan; Ikuta Hospital, No. 30057704, Shiraoi, Japan was given to TM.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Toru Mizuguchi, MD, PhD, Professor, Surgeon, Department of Nursing and Surgical Science, Sapporo Medical University, S-1, W-17, Chuo-ku, Sapporo, Hokkaido 060-8556, Japan. tmizu@sapmed.ac.jp
Telephone: +81-11-612111 Fax: +81-11-6125525
Received: March 26, 2019
Peer-review started: March 26, 2019
First decision: April 30, 2019
Revised: May 20, 2019
Accepted: May 22, 2019
Article in press: May 22, 2019
Published online: May 31, 2019
ARTICLE HIGHLIGHTS
Research background
Various minimum residual liver volume (RLV) has been presented. In addition, many formulas of standard liver volume (SLV) were also established.
Research motivation
When we planned hepatectomy for malignant tumors, we had not proven which methods were the best reliable assessment to estimate minimum RLV and SLV.
Research objectives
Aim of this study was to review previous SLV formulae and the methods used to evaluate the minimum RLV, and explore the association between liver volume and mortality.
Research methods
A systematic review was performed (No. CRD42019123642). We developed an SLV formula using data for 86 consecutive patients who underwent hepatectomy at our institution between July 2009 and August 2011.
Research results
Our formula: SLV (mL) = 822.7 × BSA − 183.2 (R2 = 0.419 and R = 0.644, P < 0.001). We retrieved 25 studies relating to SLV formulae and 12 studies about the RLV required for safe liver resection. The minimum RLV for normal and damaged livers ranged from 20%-40% and 30%-50%, respectively. The Sapporo score indicated that the minimum RLV ranges from 35%-95% depending on liver function.
Research conclusions
We reviewed SLV formulae and the minimum RLV required for safe liver resection. Although several SLV formulae have been presented, we created two simple SLV formulae that could be applied to the clinical setting. The Sapporo score is the only liver function-based method for estimating the minimum RLV.
Research perspectives
The Sapporo score should be validated by large study with prospective registration. The common SLV, which is cSLV (mL) = 710 or 770 × body surface area, needs to verify in the specific population.
