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Predictive factors of pathological vascular invasion in hepatocellular carcinoma within 3 cm and three nodules without radiological vascular invasion
Author(s) -
Masuda Toshiro,
Beppu Toru,
Okabe Hirohisa,
Nitta Hidetoshi,
Imai Katsunori,
Hayashi Hiromitsu,
Chikamoto Akira,
Yamamoto Kenichiro,
Ikeshima Satoshi,
Kuramoto Masafumi,
Shimada Shinya,
Baba Hideo
Publication year - 2016
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.12637
Subject(s) - pathological , vascular invasion , hepatocellular carcinoma , medicine , pathology , artery , gastroenterology
Aim The aim of this study was to determine the predictive factors of pathological vascular invasion as contra‐indicators for ablation therapy in patients with hepatocellular carcinoma (HCC) within 3 cm and three nodules without radiological vascular invasion. Methods Two hundred and seventeen patients with HCC within 3 cm and three nodules without radiological vascular invasion who underwent hepatic resection were retrospectively investigated. Results Pathological vascular invasion was positive in 46 patients, consisting of 38 portal vein invasions, three hepatic vein invasions, two hepatic artery invasions, one hepatic duct invasion and two with portal and hepatic vein invasions. In univariate analysis, patients with α‐fetoprotein (AFP) of more than 100 ng/mL had higher rates of pathological vascular invasion than those without. In addition, patients with protein induced by vitamin K absence (PIVKA‐II) of more than 100 mAU/mL had higher rates of pathological vascular invasion than those without. Multivariate analysis revealed that AFP of more than 100 ng/mL and PIVKA‐II of more than 100 mAU/mL were independent predictive factors for pathological vascular invasion. As these patients were treated with hepatic resection, cumulative 5‐year recurrence‐free and overall survivals were not significantly different between the pathological vascular invasion negative and positive cases. Conclusion AFP of more than 100 ng/mL and PIVKA‐II of more than 100 mAU/mL can predict pathological vascular invasion in patients with HCC within 3 cm and three nodules without radiological vascular invasion. In treating such cases, hepatic resection rather than local ablation therapy is recommended.