Understanding risk factors can guide surgical decisions for patients with hepatocellular carcinoma.

• Post-hepatectomy liver failure (PHLF) occurred in 7% of patients, linked to a 30.8% major complication rate and 9.2% 90-day mortality.
• PHLF patients had 5-year survival of 52.8%, compared to 78.8% in non-PHLF patients.

Identifying independent risk factors such as hepatitis B status and indocyanine green retention supports tailored surgical planning.

• A predictive nomogram demonstrated strong performance (AUC 0.771), allowing for better preoperative risk assessment.