The impact of anatomical resection for hepatocellular carcinoma with microvascular invasion on early tumor recurrence

Abstract

Objective To study the impact of anatomical resection (AR) for hepatocellular carcinoma with microvascular invasion on early tumor recurrence. Methods 178 consecutive patients with solitary hepatocellular carcinoma who underwent liver resection at the Affiliated Tumor Hospital of Guangxi Medical University from January 2012 to December 2015 were retrospectively studied. These patients were divi-ded into four groups according the types of resection (anatomical resection AR or non-anatomical resection NAR) and the surgical margins (narrow or wide margin). All the patients were followed up until the tumor recurred or two years after surgery. The recurrence-free survival and the types of recurrence for the 4 different groups were compared. Results The 6 months, 1-, 2-year disease-free survival rates in the AR (n=55) and NAR groups (n=123) were 87.0%, 79.2%, 74.5% and 78.5%, 61.3%, 45.7 %, respectively, (P<0.05). Through pair-wise comparisons of the four groups, there were no significant differences in early recurrence between the narrow surgical margin group and the wide surgical margin group, regardless of the types of surgery. The early recurrence rates of the AR groups were significantly lower than that of the NAR groups, regardless of the widths of the surgical margins. Multivariate analysis showed that AR was a protective factor of early recurrence (HR=0.417, 95% CI 0.229~0.761). Further analysis of the recurrence patterns of AR and NAR showed that the recurrence types were mainly solitary for AR (solitary, 61.5%; multiple 30.8%) and multiple recurrence for NAR (solitary, 32.2%; multiple 61.0%). Conclusion AR improved early recurrence-free survival of patients with microvascular invasion. Key words: Hepatocellular carcinoma; Anatomical resection (AR); Microvascular invasion (MVI); Early recurrence