Microvascular invasion risk scores affect the estimation of early recurrence after resection in patients with hepatocellular carcinoma: a retrospective study

Abstract

Background Microvascular invasion (MVI) is a histological factor that is closely related to the early recurrence of hepatocellular carcinoma (HCC) after resection. To investigate whether a noninvasive risk score system based on MVI status can be established to estimate early recurrence of HCC after resection. Methods Between January 2018 to March 2021, a total of 108 patients with surgically treated single HCC was retrospectively included in our study. Fifty-one patients were pathologically confirmed with MVI and 57 patients were absent of MVI. Univariate and multivariate logistic regression analysis of preoperative laboratory and magnetic resonance imaging (MRI) features were used to screen noninvasive risk factors in association with MVI in HCC. Risk scores based on the odds ratio (OR) values of MVI-related risk factors were calculated to estimate the early recurrence after resection of HCC. Results In multivariate logistic regression analysis, tumor size > 2 cm (P = 0.024, OR 3.05, 95% CI 1.19–11.13), Prothrombin induced by vitamin K absence-II > 32 mAU/ml (P = 0.001, OR 4.13, 95% CI 1.23–11.38), irregular tumor margin (P = 0.018, OR 3.10, 95% CI 1.16–8.31) and apparent diffusion coefficient value < 1007 × 10− 3mm2/s (P = 0.035, OR 2.27, 95% CI 1.14–7.71) were independent risk factors correlated to MVI in HCC. Risk scores of patients were calculated and were then categorized into high or low-risk levels. In multivariate cox survival analysis, only high-risk score of MVI was the independent risk factor of early recurrence (P = 0.009, OR 2.11, 95% CI 1.20–3.69), with a sensitivity and specificity of 0.52, 0.88, respectively. Conclusion A risk score system based on MVI status can help stratify patients in high-risk of early recurrence after resection of HCC.

Pre-operative enhanced magnetic resonance imaging combined with clinical features predict early recurrence of hepatocellular carcinoma after radical resection

“…MVI was found to be one of the most critical factors in predicting recurrence and survival outcomes. Approximately more than 60% of all HCC recurrences are early recurrences which are closely related to presence of MVI[ 17 , 18 ]. The present study confirmed MVI was an important predictive factor for early recurrence of HCC.…”