A System of Classifying Microvascular Invasion to Predict Outcome After Resection in Patients With Hepatocellular Carcinoma

Abstract

Background & Aims-Hepatocellular carcinoma (HCC) recurs in approximately 70% of cases after resection. Vascular invasion by tumor cells can be classified as gross or microscopic (mVI) and is a risk factor for recurrence. We examined a large cohort of patients with HCC that were treated by resection to identify features of microvascular invasion that correlated with recurrence and survival.

Utility of percutaneous radiofrequency ablation alone or combined with transarterial chemoembolization for early hepatocellular carcinoma

“…In contrast, in the treatment algorithm based on the BCLC staging system, solitary HCCs <2 cm in diameter were classified as very early stage (stage 0) (3). The 5-year OS rate of patients undergoing liver resection and liver transplant was reported as 80-90%, while it was 70% in those undergoing localized ablation (6,17,18). In addition, patients with single tumors >2 cm or three nodules <3 cm in diameter were classified as early HCC (BCLC stage A) with a 5 year OS rate of 50-70% for Data are presented as geometric median (range) or number.…”

Prediction of microvascular invasion of hepatocellular carcinoma: Usefulness of peritumoral hypointensity seen on gadoxetate disodium‐enhanced hepatobiliary phase images

“…The size, number, and nuclear grade of the tumors, presence of vascular invasion, and severity of liver disease are all regarded as important predictors of postoperative recurrence and survival (4,5). Of these, the presence of vascular invasion is considered an independent prognostic factor for tumor invasiveness that could result in metastasis (6)(7)(8). Therefore, preoperative identification of vascular invasion is important when determining the best candidates for surgical resection or liver transplantation and predicting postoperative outcome.…”

Late Extrahepatic Recurrence of Hepatocellular Carcinoma after Liver Transplantation: A Rare Case Report and Literature Review

“…≥ 5 years after LT) are unusual and only a few cases are reported in the literature. The observational study of Roayaie et al highlighted that, among 59 patients with a recurrence, only 6 (10%) patients developed a recurrence 4 or more years after transplantation [3] . In addition, only two previous case reports describe recurrences occurring over 10 years after LT [7,8] .…”

“…According to Milan criteria in the selection of "optimal candidates" to LT, the recurrence rate of HCC is reported below 15% [2] . Most recurrences appear within 2 years after LT; before transplant, the tumor factors associated with higher likelihood of recurrence are diameter > 5 cm, poor differentiation and vascular invasion [3,4] . The majority of recurrences occur within the donor liver, even if an extra-hepatic site may be involved in 10-43% of patients [4] .…”