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01-03-2014 | Hepatobiliary Tumors

The Significance of Classifying Microvascular Invasion in Patients with Hepatocellular Carcinoma

Authors: Shuji Sumie, MD, Osamu Nakashima, MD, Koji Okuda, Ryoko Kuromatsu, Atsushi Kawaguchi, MD, Masahito Nakano, PhD, Manabu Satani, MD, Shingo Yamada, MD, Shusuke Okamura, MD, Maisa Hori, MD, Tatsuyuki Kakuma, PhD, Takuji Torimura, MD, Michio Sata, MD

Published in: Annals of Surgical Oncology | Issue 3/2014

Abstract

Background

Microvascular invasion (MVI) has been recognized as a risk factor for outcome following curative resection in hepatocellular carcinoma (HCC). Because MVI can range from few to many invaded vessels, we evaluated the significance of MVI classification in this study.

Methods

Between January 1995 and December 2010, 207 consecutive patients who underwent curative resection for HCC within Milan criteria were included in this retrospective study. Patients were classified into mild and severe MVI groups based on the number of vessels invaded. This study evaluated whether MVI classification can help to predict recurrence and survival after curative resection.

Results

Of the total 207 patients, 103 (50 %) patients had no detectable MVI, whereas 59 (28 %) had mild MVI, and 45 (22 %) had severe MVI. Recurrence-free survival rates at 2 years for patients without MVI, with mild MVI, and severe MVI were 75.9, 47.2, and 32.7 %, respectively. Patients with severe MVI experienced a high frequency of fatal recurrence, such as multiple tumors, macroscopic vascular invasion, and extrahepatic metastasis after curative resection. Multivariate analysis revealed age, number of tumors, mild MVI, and severe MVI as independent predictors of recurrence-free survival. Disease-specific survival rates at 5 years for patients without MVI, with mild MVI, and severe MVI were 91.5, 70.4, and 51.4, respectively. Multivariate analysis also revealed cirrhosis, tumor size, mild MVI, and severe MVI as independent predictors of disease-specific survival.

Conclusions

We demonstrated that MVI classification can stratify HCC patients by different patterns of recurrence and risk of survival after curative resection.

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Title: The Significance of Classifying Microvascular Invasion in Patients with Hepatocellular Carcinoma
Authors: Shuji Sumie, MD
Osamu Nakashima, MD
Koji Okuda
Ryoko Kuromatsu
Atsushi Kawaguchi, MD
Masahito Nakano, PhD
Manabu Satani, MD
Shingo Yamada, MD
Shusuke Okamura, MD
Maisa Hori, MD
Tatsuyuki Kakuma, PhD
Takuji Torimura, MD
Michio Sata, MD
Publication date: 01-03-2014
Publisher: Springer US
Published in: Annals of Surgical Oncology / Issue 3/2014
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-013-3376-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The Significance of Classifying Microvascular Invasion in Patients with Hepatocellular Carcinoma

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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