Influence of microvascular invasion on progression-free survival in patients with a solitary small he-patocellular carcinoma

Abstract

Objective To study the influence of microvascular invasion (MVI) on progression-free survival (PFS) in patients with a solitary small hepatocellular carcinoma, and to analyze the risk factors of MVI. Methods 126 patients with a solitary small hepatocellular carcinoma who underwent liver resection at Tianjin Medical University Cancer Hospital from January 2010 to December 2012 were retrospectively stu-died. Their demographic and clinicopathological characteristics including age, gender, HBV infection, HCV infection, alcohol consumption, comorbidity, liver cirrhosis, ascites, tumor size, tumor differentiation, MVI, satellite lesion, AFP, CA19-9, ALT and TBil were analyzed. Results The 1-, 2- and 3-year PFS rates of patients with a solitary small hepatocellular carcinoma were 81.0%, 60.3% and 47.3% after surgical resection, respectively. Univariate analysis revealed that MVI, comorbidity, non-well-differentiated tumor, tumor size >4 cm were risk factors of PFS. Multivariate analysis demonstrated that only MVI and comorbidity were independent factors of PFS. MVI occurred in 43.7% of the patients. The median PFS of patients without MVI was 45 months, and the 1-, 2- and 3-year PFS rates of these patients were 91.5%, 67.6% and 56.0%, respectively. The median PFS of patients with MVI was 30 months, and the 1-, 2- and 3-year PFS rates were 67.3%, 50.9% and 35.4%, respectively. On univariate analysis, AFP >100 μg/L, non-well-differentiated tumor and satellite lesions were significantly associated with MVI. On multivariate analysis only non-well-differentiated tumor was independently associated with MVI. Conclusions MVI was an important factor affecting PFS in patients with a solitary small hepatocellular carcinoma. AFP>100 μg/L, non-well-differentiated tumor and satellite lesions were risk factors of MVI. Key words: Solitary small hepatocellular carcinoma; Progression-free survival; Microvascular invasion; Risk factors