Applicants:
Erik Schadde, Massimo Malago, Elio Jovine, Eddie Abdalla, Eduardo de Santibanes
Department / Institution:
Hospital Italiano de Buenos Aires, Argentina | Royal Free Hospital, UCLH London, UK
Background:
The size of the future liver remnant is one important criterion to assess resectability
of liver tumors and is generally expressed as a proportion of the total liver volume.
Total liver volume may either be measured on crossectional imaging or extrapolated
for each individual patient based on their biometric data and is then called
“standardized total liver volume”. Especially in conditions like steatosis or fibrosis
/cirrhosis, standardized total liver volume may better correlate better with the
metabolic demands of each patient. Many formulas have been proposed to estimate
the standard liver volume mostly based on weight on height. The formula most widely
used by surgeons is the Vauthey formula (Liver Transplantation 2002). The ALPPS
registry is likely the largest collection of measured total liver volumes from over 70
centres in 48 countries and also accumulates the largest diversity of ethnic
backgrounds.
Objectives:
The aim of this study is to validate the most commonly used formulas for total liver
volume in 400 patients recorded in the ALPPS registry and determine which best
predicts liver volume as measured in the ALPPS registry. If correlation is insufficient
our goal will be to develop a new model.
Methods:
1. Validation of 16 current formulas for total volume using the available biometric
data and measured liver volumes from the ALPPS registry (correlation
analysis)
2. Identification of populations with higher or lower correlations in a multivariate
analysis
3. Comparison of the fit between models using receiver-operating curves and
AUC analysis.
4. Development of a novel linear or nonlinear model for total liver volume based
on the ALPPS registry in case none of the existing models is appropriate.