Volume change of segments II and III of the liver after gastrectomy in patients with gastric cancer

Abstract

Purpose: We aimed to evaluate the relationship between gastrectomy and the volume of liver segments II and III in patients with gastric cancer.

Methods: Computed tomography images of 54 patients who underwent curative gastrectomy for gastric adenocarcinoma were retrospectively evaluated by two blinded observers. Volumes of the total liver and segments II and III were measured. The difference between preoperative and postoperative volume measurements was compared.

Results: Total liver volumes measured by both observers in the preoperative and postoperative scans were similar (P > 0.05). High correlation was found between both observers (preoperative r=0.99; postoperative r=0.98). Total liver volumes showed a mean reduction of 13.4% after gastrectomy (P = 0.977). The mean volume of segments II and III showed similar decrease in measurements of both observers (38.4% vs. 36.4%, P = 0.363); the correlation between the observers were high (preoperative r=0.97, P < 0.001; postoperative r=0.99, P < 0.001). Volume decrease in the rest of the liver was not different between the observers (8.2% vs. 9.1%, P = 0.388). Time had poor correlation with volume change of segments II and III and the total liver for each observer (observer 1, rseg2/3=0.32, rtotal=0.13; observer 2, rseg2/3=0.37, rtotal=0.16).

Conclusion: Segments II and III of the liver showed significant atrophy compared with the rest of the liver and the total liver after gastrectomy. Volume reduction had poor correlation with time.

Figure 1

a–d. A 62-year-old man with gastric cancer. Preoperative CT (a) reveals a parenchymal cyst in segment 2. In the control CT image (b) obtained four years after total gastrectomy, the parenchymal cyst shrunk as well as segments II and III. Preoperative volumetric measurement of segments II and III is 225 mL (c). Four years later, the volume of segments II and III decreased to 56 mL (d).

Figure 2

a, b. A 58-year-old man with gastric cancer. Preoperative CT (a) reveals a normal liver. Two years after distal subtotal gastrectomy (b), segments II and III adjacent to the portal vein are almost invisible. Preoperative volumetric measurement of the segments II and III was 237 mL which decreased to 35.7 mL two years after the operation.