Liver and spleen assessment should be assessed for regression, stability and increase as estimated by imaging or palpation.
- A liver or spleen is considered enlarged when it is below the costal margin.
- Any unequivocal increase in the size of the liver or spleen can be considered evidence of progressive disease.
- While physical exam may be sufficient to approximate an unequivocal increase in size of liver and spleen, imaging will be particularly important:
- If the size of the liver or spleen is questionable on physical exam
- If the liver or spleen was enlarged at baseline and a return to normal size is being used to confirm a response