Hepatocellular carcinoma (HCC) accounts for around 90% of liver cancer cases [1]. In recent years, the progressive advancements in surveillance, diagnosis and treatment have led to earlier diagnosis and curative treatment [2]. Although the continuous improvement of perioperative management has not reduced the rate of HCC recurrence. Studies show that the cumulative 5-year recurrence rate for HCC patients after hepatic resection was around 80% [3-4]. Splenic volume has been shown to be a reliable marker for the degree of liver cirrhosis and portal hypertension in...

HCC patients who had either a liver resection or ablation with 2 years of complete resolution were identified from a prospective Austin Health hepatoma database. All patients in the study received an abdominal CT scan before their procedure. The patient's pre-operative CT scans were used to calculate Liver and spleen volumes using a semi-automated volumetric analysis software available on the website medseg.ai (Figure 1). [Fig 1] Statistical correlation with multiple regression analysis was used to correlate the spleen volume and spleen to liver volume ratio...

Seventy six patients aged 63.1 ± 8.6 (± SD) years were included in the study (Table 1). The aetiology of liver cirrhosis in the patient cohort included a combination of viral hepatitis (75%), alcoholic cirrhosis (26%) and non-alcoholic steatohepatitis (NASH) (12%). There was late recurrence of HCC in nearly half of the patients (45%) and 26% were deceased at the end of the follow-up period. [Fig 3] The mean liver volume of all patients was 1,779 mls ± 596 mls (± SD) (Table 2) and...

Pre-operative spleen to liver volume ratio was found to be significantly correlated with mortality in HCC patients. This correlation exists because of the association between splenic volume with liver cirrhosis and portal hypertension. It was found that spleen volume was not significantly correlated with mortality but a trend towards correlation was shown. This study also provided foundational work for future studies on semi-automated CT organ volumetry analysis. These findings could guide further studies to improve the clinical surveillance and management of late recurrence of HCC.

A. T. Tran: Nothing to disclose

[1] Llovet JM. Hepatocellular carcinoma. Lancet. 2003;362:1907-17. [2]Fang T, Long G, Mi X, Su W, Mo L, Zhou L. Splenic Volume, an Easy-To-Use Predictor of HCC Late Recurrence for HCC Patients After Hepatectomy. Frontiers in oncology. 2022 May 24;12:876668. [3] Taura K, Ikai I, Hatano E, Fujii H, Uyama N, Shimahara Y. Implication of frequent local ablation therapy for intrahepatic recurrence in prolonged survival of patients with hepatocellular carcinoma undergoing hepatic resection: an analysis of 610 patients over 16 years old. Annals of surgery. 2006...