Abstract: Objective To evaluate the efficacy of the %RLV（remnant liver volume to total liver volume），RLV/SLV（remnant liver volume to standard liver volume），RLV/BW（remnant liver volume to body weight ratio），and SRLV（standard remnant liver volume） in predicting post-hepatectomy liver failure（PHLF） in hepatocellular carcinoma（HCC） patients under hemihepatectomy. Method Totals of 1，446 patients with hepatitis B virus-associated HCC，who underwent hemihepatectomy in Guangxi Medical University Cancer Hospital from September 2013 to August 2016，were collected and divided into a PHLF group and a PHLF-free group according to whether PHLF occurred after hemihepatectomy. The ROC curve was used to analyze the efficacy of %RLV，RLV/BW，RLV/SLV and SRLV in predicting PHLF. The incidence of postoperative complications between the two groups of patients were compared. Result A total of 181 patients were enrolled in the study，including 22 cases in the PHLF group and 159 cases in the PHLF-free group. There was a statistically significant difference in %RLV，RLV/BW，RLV/SLV，and SRLV between the two groups（P＜0.05）. ROC curve analysis showed that the areas under the curves（AUC） of %RLV，RLV/SLV，RLV/BW，and SRLV were 0.77，0.91，0.84，and 0.91，respectively. The effectiveness of SRLV in predicting postoperative PHLF was better than %RLV and RLV/BW（P<0.05）. According to the SRLV cutoff value of 340 mL/m2，patients were divided into SRLV>340 mL/m² group and SRLV≤340 mL/m2 group. The incidence of severe postoperative complications in patients with SRLV>340 mL/m² was statistically significant compared with SRLV≤340 mL/m²（P<0.01）. Conclusion SRLV and RLV/SLV are more effective than RLV/BW and %RLV in predicting PHLF in HCC patients after hepatectomy，and the incidence of PHLF and severe complications are higher when SRLV≤340 mL/m².

Key words: Hepatocellular carcinoma, Liver failure, Liver volume, Hepatectomy