To assess the predictive value of liver stiffness measurement (LSM) and standard remnant liver volume (SRLV) for hepatic insufficiency in hepatocellular carcinoma (HCC) patients after hemihepatectomy.

Clinical data of 28 HCC patients who underwent hemihepatectomy in Nantong Third People's Hospital Affiliated to Nantong University from June 2016 to February 2020 were retrospectively analyzed. Among them, 20 patients were male and 8 female, aged (57±9) years on average. The informed consents of all patients were obtained and the local ethical committee approval was received. LSM was measured by transient elastography, and SRLV was measured by CT scan. According to the incidence of hepatic insufficiency, all patients were divided into the hepatic insufficiency (n=10) and non-hepatic insufficiency (n=18) groups. The risk factors for postoperative hepatic insufficiency were identified by Chi-square test and multivariate Logistic regression analysis. The predictive value of LSM and SRLV for postoperative hepatic insufficiency was evaluated by the receiver operating characteristic (ROC) curve.

In the hepatic insufficiency group, LSM and SRLV were (27±6) kPa and (267±46) ml/m2, which significantly differed from (17±5) kPa and (366±60) ml/m² in the non-hepatic insufficiency group (t=23.730, -20.422; P<0.05). Multivariate Logistic regression analysis showed that LSM≥25 kPa and SRLV≤290 ml/m² were the independent risk factors for postoperative hepatic insufficiency (OR=17.448, 24.690; P<0.05). ROC curve analysis demonstrated that LSM=17 kPa and SRLV=266 ml/m² yielded the highest sensitivity and specificity in predicting postoperative complications, and the areas under ROC curve were 0.894 and 0.903 (Z=6.684, 6.763; P<0.05).

Preoperative detection of LSM and SRLV can be utilized to predict hepatic insufficiency in HCC patients after hemihepatectomy.