Abstract
Background: Standard liver volume (SLV) is important in risk assessment for major hepatectomy. We aimed to investigate the growth patterns of normal liver volume with age and body weight (BW) and summarize formulae for calculating SLV in children.Methods: Overall, 792 Chinese children (<18 years of age) with normal liver were enrolled. Liver volumes were measured using computed tomography. Correlations between liver volume and BW, body height (BH), and body surface area (BSA) were analyzed. New SLV formulae were selected from different regression models; they were assessed by multicentral validations and were compared.Results: The growth patterns of liver volume with age (1 day−18 years) and BW (2–78 kg) were summarized. The volume grows from a median of 139 ml (111.5–153.6 in newborn) to 1180.5 ml (1043–1303.1 at 16–18 years). Liver volume was significantly correlated with BW (r = 0.95, P < 0.001), BH (r = 0.92, P < 0.001), and BSA (r = 0.96, P < 0.001). The effect of sex on liver volume increases with BW, and BW of 20 kg was identified as the optimal cutoff value. The recommended SLV formulae were BW≤20 kg: SLV = 707.12 × BSA1.09; BW>20 kg, males: SLV = 691.90 × BSA1.06; females: SLV = 663.19 × BSA1.04.Conclusions: We summarized the growth patterns of liver volume and provided formulae predicting SLV in Chinese children, which is useful in assessing the safety of major hepatectomies.
Highlights
The most common liver tumor in children is hepatoblastoma [1]
New standard liver volume (SLV) formulae were selected from different regression models; they were assessed by multicentral validations and were compared
Liver volume was significantly correlated with body weight (BW) (r = 0.95, P < 0.001), body height (BH) (r = 0.92, P < 0.001), and body surface area (BSA) (r = 0.96, P < 0.001)
Summary
The most common liver tumor in children is hepatoblastoma [1]. The main treatment of hepatoblastoma is surgical resection combined with neoadjuvant therapy [2]. Extreme surgical resection after careful preoperative evaluation has similar overall survival rate with liver transplantation in some posttreatment extent (POST-TEXT) III and IV hepatoblastoma [3,4,5]. It provides options for advanced-stage hepatoblastoma patients in the transplant waiting list and avoids long-term treatment of immunosuppression after transplantation [3, 6]. We aimed to investigate the growth patterns of normal liver volume with age and body weight (BW) and summarize formulae for calculating SLV in children
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