title: Platelet count is more useful for predicting posthepatectomy liver failure at surgery for hepatocellular carcinoma than indocyanine green clearance test.
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Surgery, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan.|Department of Surgery, Toyonaka Municipal Hospital, Toyonaka, Osaka, Japan.
authors.forename: Yoshito
authors.initials: Y
authors.lastname: Tomimaru
authors.affiliation: Department of Surgery, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan.
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Eguchi
authors.affiliation: Department of Surgery, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan.
authors.forename: Kunihito
authors.initials: K
authors.lastname: Gotoh
authors.affiliation: Department of Surgery, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Kawamoto
authors.affiliation: Department of Surgery, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Wada
authors.affiliation: Department of Surgery, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan.
authors.forename: Tadafumi
authors.initials: T
authors.lastname: Asaoka
authors.affiliation: Department of Surgery, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan.
authors.forename: Takehiro
authors.initials: T
authors.lastname: Noda
authors.affiliation: Department of Surgery, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan.
authors.forename: Daisaku
authors.initials: D
authors.lastname: Yamada
authors.affiliation: Department of Surgery, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan.
authors.forename: Hisataka
authors.initials: H
authors.lastname: Ogawa
authors.affiliation: Department of Surgery, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Umeshita
authors.affiliation: Department of Surgery, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Nagano
authors.affiliation: Department of Surgery, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan.
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Doki
authors.affiliation: Department of Surgery, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Mori
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000378:metabolism* / Q000601:surgery; D004396:Coloring Agents / Q000493:pharmacokinetics; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D007208:Indocyanine Green / Q000493:pharmacokinetics*; D017093:Liver Failure / Q000453:epidemiology* / Q000378:metabolism; D008113:Liver Neoplasms / Q000378:metabolism* / Q000601:surgery; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D011183:Postoperative Complications / Q000453:epidemiology* / Q000378:metabolism; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D004396:Coloring Agents; D007208:Indocyanine Green
keywords: hepatectomy; hepatocellular carcinoma; indocyanine green; platelet; posthepatectomy liver failure