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Outcomes and predictors of microvascular invasion of solitary hepatocellular carcinoma
Author(s) -
Hirokawa Fumitoshi,
Hayashi Michihiro,
Miyamoto Yoshiharu,
Asakuma Mitsuhiro,
Shimizu Tetsunosuke,
Komeda Koji,
Inoue Yoshihiro,
Uchiyama Kazuhisa
Publication year - 2014
Publication title -
hepatology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.123
H-Index - 75
eISSN - 1872-034X
pISSN - 1386-6346
DOI - 10.1111/hepr.12196
Subject(s) - hepatocellular carcinoma , medicine , odds ratio , confidence interval , hepatectomy , gastroenterology , multivariate analysis , univariate analysis , overall survival , retrospective cohort study , carcinoma , surgical margin , resection , oncology , surgery , cancer
Aim Microvascular invasion ( MVI ) is an important risk factor for early recurrence of hepatocellular carcinoma ( HCC ), but preoperative prediction of MVI is difficult. Methods A retrospective review was undertaken on 167 patients with primary solitary HCC who underwent initial hepatectomy. Independent predictors of MVI were identified, and factors affecting disease‐free survival in patients with MVI were clarified. Results Of the 167 patients, 20 patients (12%) had MVI . Recurrence rates of HCC after hepatectomy in MVI patients were significantly worse than in patients without MVI ( P < 0.0361). Univariate analysis revealed that positive L3‐ AFP , PIVKA‐II ≥ 150 mAU/mL and tumor size ≥3 cm preoperatively were associated with positive MVI . On multivariate analysis, independent predictors of MVI were PIVKA‐II ≥ 150 mAU/mL (odds ratio [ OR] , 5.19; 95% confidence interval [95% CI ], 1.44–24.87; P = 0.0109) and positive L3 ‐ AFP ( OR , 3.47; 95% CI , 1.19–10.75; P = 0.0229). Among the MVI ‐positive group, the 1‐, 2‐ and 3‐year disease‐free survival rates were 78%, 58%, and 58% in patients with surgical margin ( SM ) ≥ 10 mm and 38%, 29%, and 29% in those with SM < 10 mm, respectively ( P = 0.0263). Conclusions Patients with PIVKA‐II ≥ 150 mAU/mL and positive L3 ‐ AFP on preoperative examination are at high risk for MVI .