Abstract
ObjectivesThe aim of this study was to investigate the prognostic value and preoperative predictors of microvascular invasion (MVI) in solitary hepatocellular carcinoma (HCC) ≤ 5 cm without macrovascular invasion.MethodsA total of 233 consecutive HCC patients underwent curative hepatectomy were included in our study. Independent risk factors influencing the prognosis were identified, and preoperative predictors for MVI were determined.ResultsMultivariate regression analysis identified ICG-R15, BCLC staging and MVI as independent risk factors for the overall survival rate. Type of resection and MVI were independent risk factors for the recurrence-free survival rate. Kaplan-Meier analysis showed the overall survival and recurrence-free survival rates in patients with MVI were significantly poorer than those in patients without MVI (P = 0.002 and P = 0.001). Anatomical resection obviously improved the overall survival and recurrence-free survival rates in patients with MVI compared with non-anatomical resection (P = 0.017 and P = 0.009). A prediction scoring system for MVI was built up according to the three independent predictors (tumor size > 3.5 cm, AFP > 200 ng/mL and GGT > 53 U/L). The prevalence of MVI in HCC patients with predictive score ≥ 2 was 58.3%, which was obviously higher than patients with predictive score < 2 (20.8%).ConclusionsMVI is associated with a poor prognosis in solitary HCC ≤ 5 cm after hepatectomy. Anatomical resection could improve the prognosis of HCC patients with MVI. The preoperative prediction scoring model has practical value for the prediction of MVI.
Highlights
Hepatocellular carcinoma (HCC) is the sixth most common malignancy and the third leading cause of cancerrelated death worldwide [1]
Anatomical resection obviously improved the overall survival and recurrence-free survival rates in patients with microvascular invasion (MVI) compared with non-anatomical resection (P = 0.017 and P = 0.009)
A prediction scoring system for MVI was built up according to the three independent predictors
Summary
Hepatocellular carcinoma (HCC) is the sixth most common malignancy and the third leading cause of cancerrelated death worldwide [1]. Results: Multivariate regression analysis identified ICG-R15, BCLC staging and MVI as independent risk factors for the overall survival rate. Univariate and multivariate analysis of prognostic risk factors for the entire cohort In univariate analysis, Child–Pugh grade, ICG-R15, BCLC staging, tumor size, type of resection and MVI significantly influenced the overall survival rate (Table 2).
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