Abstract
ObjectivesThe present research aimed to evaluate the prognostic value of a novel risk classification of microvascular invasion (MVI) in hepatocellular carcinoma (HCC) after resection.MethodsA total of 295 consecutive HCC patients underwent hepatectomy were included in our study. We evaluated the degree of MVI according to the following three features: the number of invaded microvessels (≤5 vs >5), the number of invading carcinoma cells (≤ 50 vs >50), the distance of invasion from tumor edge (≤1 cm vs >1 cm).ResultsAll patients were divided into three groups according to the three risk factors of MVI: non-MVI group (n=180), low-MVI group (n=60) and high-MVI group (n=55). The overall survival (OS) and recurrence-free survival (RFS) rates of high-MVI group were significantly poorer than those of low-MVI and non-MVI groups (P<0.001 and P=0.001; P<0.001 and P=0.003). Multivariate analysis showed high-MVI, type of resection, ICG-R15 and tumor size were risk factors for OS after hepatectomy. High-MVI, type of resection and tumor size were risk factors for RFS. In subgroup analyses, the OS and RFS rates of low-MVI and non-MVI groups were better than high-MVI group regardless of tumor size. In high-MVI group, anatomical liver resection (n=28) showed better OS and RFS rates compared with non-anatomical liver resection (n=29) (P=0.012 and P=0.002).ConclusionsThe novel risk classification of MVI based on histopathological features is valuable for predicting prognosis of HCC patients after hepatectomy.
Highlights
In the world, hepatocellular carcinoma (HCC) is the sixth most common malignant tumors and the third most common cause of tumors related death [1]
The novel risk classification of Microvascular invasion (MVI) based on histopathological features is valuable for predicting prognosis of HCC patients after hepatectomy
70% of HCC patients have a recurrence within the 5 years after curative Hepatectomy [3]
Summary
Hepatocellular carcinoma (HCC) is the sixth most common malignant tumors and the third most common cause of tumors related death [1]. 70% of HCC patients have a recurrence within the 5 years after curative Hepatectomy [3]. The important mechanism for intrahepatic metastases is that tumor cells invade through portal vein or hepatic vein branches [4]. Microvascular invasion (MVI), defined as the invasion of tumor cells in intrahepatic portal vein or hepatic vein branches, is generally considered as a risk factor for the overall survival and recurrence rates of postoperative HCC patients [5]. Some studies indicated different histopathological characteristics of MVI had different prognostic outcomes [7, 8]. More than 50 invading tumor cells and multiple-invaded microvessels might be related to the poor survival and recurrence rates in the previous study [9]. There is no definite risk classification of MVI based on histopathological characteristics
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