Clinical Research Papers:
Prognostic value of a novel risk classification of microvascular invasion in patients with hepatocellular carcinoma after resection
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Hui Zhao1,2,*, Chuang Chen1,3,*, Xu Fu4,*, Xiaopeng Yan4, Wenjun Jia4, Liang Mao4, Huihan Jin2 and Yudong Qiu1,4
1 Department of Hepatopancreatobiliary Surgery, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, Jiangsu, China
2 Department of Hepatopancreatobiliary Surgery, Nanjing Medical University Affiliated Wuxi Second Hospital, Wuxi, Jiangsu, China
3 Department of Hepatopancreatobiliary Surgery, Huai’an Hospital Affiliated to Xuzhou Medical University, Second People’s Hospital of Huai’an City, Huai’an, Jiangsu, China
4 Department of Hepatopancreatobiliary Surgery, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, Jiangsu, China
* These authors have contributed equally to this work
Correspondence to:
Yudong Qiu, email:
Huihan Jin, email:
Keywords: hepatocellular carcinoma; microvascular invasion; risk classification; prognosis
Received: July 16, 2016 Accepted: September 21, 2016 Published: October 09, 2016
Abstract
Objectives: The present research aimed to evaluate the prognostic value of a novel risk classification of microvascular invasion (MVI) in hepatocellular carcinoma (HCC) after resection.
Methods: A total of 295 consecutive HCC patients underwent hepatectomy were included in our study. We evaluated the degree of MVI according to the following three features: the number of invaded microvessels (≤5 vs >5), the number of invading carcinoma cells (≤ 50 vs >50), the distance of invasion from tumor edge (≤1 cm vs >1 cm).
Results: All patients were divided into three groups according to the three risk factors of MVI: non-MVI group (n=180), low-MVI group (n=60) and high-MVI group (n=55). The overall survival (OS) and recurrence-free survival (RFS) rates of high-MVI group were significantly poorer than those of low-MVI and non-MVI groups (P<0.001 and P=0.001; P<0.001 and P=0.003). Multivariate analysis showed high-MVI, type of resection, ICG-R15 and tumor size were risk factors for OS after hepatectomy. High-MVI, type of resection and tumor size were risk factors for RFS. In subgroup analyses, the OS and RFS rates of low-MVI and non-MVI groups were better than high-MVI group regardless of tumor size. In high-MVI group, anatomical liver resection (n=28) showed better OS and RFS rates compared with non-anatomical liver resection (n=29) (P=0.012 and P=0.002).
Conclusions: The novel risk classification of MVI based on histopathological features is valuable for predicting prognosis of HCC patients after hepatectomy.