| Objective: To compare the prognosis of different surgical margins on solitary hepatocellular carcinoma with or without microvascular invasion(MVI),and discuss the risk factors of MVI.Method: The clinicopathological data of solitary hepatocellular carcinoma patients who underwent radical resection in Fffiliated Tumor Hospital of Guangxi Medical University from January 2014 to February 2015 was analyzed.The tumor recurrence and overall survival(OS)rate were estimated by Kaplan-meier method and logarithmic rank test(Log-rank),and the recurrence and survival curves were plotted.Cox proportional risk model is used to determine the independent risk factors for tumor recurrence and OS.The risk factors of MVI were analyzed by logistic regression.Result: MVI was histologically present in 89 patients(89/184,48.4%).The prognosis of wide margin(?1cm,n=42)was better than narrow margin(<1cm,n=47)in patients with MVI(1,2,3-year recurrence and OS rate:16.6%,50.1%,61.9% vs.57.2%,78.8%,85.1%;95.2%,92.9%,81.0% vs.76.6%,74.6%,59.5%,both p<0.05),but not in patients without MVI.Multivariate Cox regression analysis showed that narrow margin(HR 2.83;95%CI 1.62-4.93)and incomplete envelope(HR 1.88 95%CI 1.10-3.23)were independent risk factors of tumor recurrence,and narrow margin(HR 3.03;95%CI 1.08-8.53)is an independent risk factor of OS(HR 3.03;95%CI1.08-8.53)in patients with MVI(both p<0.05).Postoperative adjuvant TACE significantly reduce tumor recurrence(HR 0.032;95%CI 0.017-0.62)and increase overall survival(HR 0.09;95%CI 0.02-0.32)in patients with MVI(both p<0.05).Multivariate logistic regression analysis showed tumor diameter >5cm and low differentiation were independent risk factors of MVI in hepatocellular carcinoma patients(p=0.003,p=0.026).Conclusion: Tumor diameter >5cm and low differentiation are the high risk factors of MVI.Wide margin and postoperative adjuvant TACE can reduce the early recurrence rate and prolong the survival time on solitary hepatocellular carcinoma patients with MVI. |
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