Prognostic Value Of Microvascular Invasion In Patients With Hepatocellular Carcinoma After Resection

Objective;To research the prognostic value of microvascular invasion(MVI)in patients with hepatocellular carcinoma(HCC)after resection and to assess the efficacy of different postoperative adjuvant treatments in hepatocellular carcinoma patients with microvascular invasion after resection.Methods:From 2016 to 2017,the clinical date of 277 hepatocellular carcinoma patients undergoing hepatectomy in our hospital was retrospectively analyzed.The clinical pathologic characteristics and survival data between HCC patients with MVI and patients without MVI were compared and the prognosis of different postoperative adjuvant treatments in HCC patients with MVI after resection was analyzed by using SPSS 25.0 software.Results:MVI was histologically present in 277 patients(100/277,36.1%).Survival analysis revealed that overall survival(OS)and recurrence-free survival(RFS)rates of HCC patients with MVI were significantly poorer than those of patients without MVI(P<0.001).The independent risk factors of MVI in hepatocellular carcinoma patients included tumor diameter>5cm,low differentiation and presence of satellite nodules(p=0.002,p=0.023>p=0.001).Multivariate analysis indicated that AFP>400ng/ml(HR 2.354;95%Cl 1.206-4.595),Albumin<40g/L(HR 2.851;95%CI 1.258-6.459),PT>13.2 S(HR 3.402;95%CI 1.362-8.496),blood loss>600ml(HR 3.664;95%CI 1.607-8.355)were independent risk factors of tumor recurrence,and AFP>400ng/ml(HR 4.483;95%CI 1.450-13.855),AST>40U/L(HR4.149;95%CI1.186-14.508),Albumin<40g/L(HR 6.953;95%Cl 1.863-25.951),blood loss>600ml(HR3.774;95%CI 1.051-13.555)were independent risk factors of OS in patients with MVI(both p<0.05).Postoperative adjuvant treatments significantly increased overall survival(p=0.07),while there was no significant difference for the RFS rate in patients with MVI.Furthermore,better OS rate was observed in the group of postoperative adjuvant radiotherapy compared with the group of transcatheter arterial chemoembolization(TACE).Conclusion:The independent risk factors of MVI in hepatocellular carcinoma patients include tumor diameter>5cm,low differentiation and presence of satellite nodules.The overall survival(OS)and recurrence-free survival(RFS)rates of HCC patients with MVI are significantly poorer than those of patients without MVI.Postoperative adjuvant treatments significantly increase overall survival in patients with MVI.Postoperative adjuvant radiotherapy offers better OS for HCC patients with MVI than TACE.