Analysis Of The Relevant Factors Influencing Prognosis Of Solitary Hepatocellular Carcinoma Patients Withs Microvascular Invasion

Aims: To discuss the factors influencing prognosis of solitary hepatocellular carcinoma(HCC)patients with microvascular invasion(MVI)and to provide theoretical basis for the clinical treatment and prognosis assessment.Methods: Medical records of HCC patients who received radical resection in the Department of Hepatobiliary Surgery at Guangxi Medical University Affiliated Tumor Hospital from January 2012 to December2014 were retrospectively analyzed.Among them,152 cases of solitary HCC of which postoperative pathology clearly revealed the existence of MVI were selected.In order to provide theoretical basis for the clinical treatment and prognosis assessment for solitary HCC patients with MVI,18 relevant variables influencing prognosis of solitary HCC patients with MVI were analyzed,including gender,age,aspartate aminotransferase,alanine transaminase,albumin,total bilirubin,blood platelet,coagulationtime,glutamyl transpeptidase,hepatitis b surface antigen positive or not,cirrhosis or not,maximum diameter of tumor,tumor hemorrhage or not,integrity of capsule,CA199,alpha fetoprotein,intraoperative blood loss,postoperative TACE or not,etc.The data was calculated and analyzed with SPSS 19.9 software;the survival rate was calculated using Kaplan-Meier method;single factor analysis was conducted using log-rank test,and multi-factor analysis was carried out using COX model.The factors influencing prognosis of single HCC patients with MVI were finally selected.Results: According to the follow-up by December 31,2016,there were132 male patients and 20 female patients among the 152 cases,with an average age of 47.47±10.40,the oldest 76 and the youngest 26.There were a total of 76 cases of recurrence and 23 cases of death.The median disease-free survival time was 16 months and the median overall survival time was 57 months.The 1,2,and 3 years' disease-free survival time was58.1%,38.8% and 25.7% respectively.The 1,2,and 3 years' cumulative-survival rate was 93.3%,85.8% and 82.0% respectively.The single factor analysis results showed that there was no significant correlation(P > 0.05)between the prognosis of solitary HCC patients with MVI and these factors: gender,age,alanine transaminase,albumin,total bilirubin,blood platelet,glutamyl transpeptidase,hepatitis b surface antigen positive or not,cirrhosis or not,CA199,alpha fetoprotein,and postoperative TACE or not.Hemorrhage,maximum diameter of tumor>5cm,and intraoperative blood loss > 500 m L were the relevant factors influencing disease-free survival,while incomplete tumor capsule,preoperative AST > 40U/L and PT ? 14 S were the relevant factors influencing overall survival(P<0.05).The multi-factor analysis results showed that intraoperative blood loss > 500 m L was the independent prognostic factor influencing disease-free survival,while preoperative AST > 40U/L and PT ? 14 S were the independent prognostic factors influencing overall survival.Conclusions: For solitary HCC patients with MVI,intraoperative blood loss > 500 m L was the independent prognostic factor influencing disease-free survival.While preoperative AST > 40 U/L and PT?14S were the independent prognostic factors influencing overall survival.