Platelet count is more useful for predicting posthepatectomy liver failure at surgery for hepatocellular carcinoma than indocyanine green clearance test

J Surg Oncol. 2016 Apr;113(5):565-9. doi: 10.1002/jso.24166. Epub 2016 Jan 11.

Abstract

Background and objectives: Preoperatively evaluating reserved liver function is critical in preventing posthepatectomy liver failure (PHLF) in patients undergoing liver resection. The commonly used indocyanine green (ICG) clearance test has several drawbacks. Patients would benefit from a more reliable and straightforward means of assessing the risk of PHLF.

Methods: This study included 277 patients with hepatocellular carcinoma (HCC) undergoing liver resection. The predictive value of known risk factors for PHLF was compared to that of ICG.

Results: PHLF was identified in 25 out of 277 patients (9.0%). Multivariate logistic regression analysis for identifying predictors for the PHLF development revealed platelet count and resected liver volume as significant independent predictors. In a subgroup analysis based on resected liver volume, platelet count was significantly correlated with PHLF in both larger volume (≥100 g) and smaller volume resection groups (<100 g), although ICG R15 level was associated with PHLF only in larger volume group.

Conclusions: Platelet count is superior to ICG R15 level in predicting PHLF development in HCC patients. J. Surg. Oncol. 2016;113:565-569. © 2016 Wiley Periodicals, Inc.

Keywords: hepatectomy; hepatocellular carcinoma; indocyanine green; platelet; posthepatectomy liver failure.

MeSH terms

  • Aged
  • Carcinoma, Hepatocellular / metabolism*
  • Carcinoma, Hepatocellular / surgery
  • Coloring Agents / pharmacokinetics
  • Female
  • Hepatectomy / adverse effects*
  • Humans
  • Incidence
  • Indocyanine Green / pharmacokinetics*
  • Liver Failure / epidemiology*
  • Liver Failure / metabolism
  • Liver Neoplasms / metabolism*
  • Liver Neoplasms / surgery
  • Logistic Models
  • Male
  • Middle Aged
  • Platelet Count*
  • Postoperative Complications / epidemiology*
  • Postoperative Complications / metabolism
  • Predictive Value of Tests
  • Retrospective Studies
  • Risk Factors

Substances

  • Coloring Agents
  • Indocyanine Green