The Predictive Value of Vessels Encapsulating Tumor Clusters in Treatment Optimization for Recurrent Early-Stage Hepatocellular Carcinoma

Abstract

Background. The vessels encapsulating tumor clusters (VETC) pattern is an effective predictor of survival in patients with hepatocellular carcinoma (HCC) after resection. The predictive value of VETC in recurrent early-stage HCC remains unclear. Therefore, the aim of the present study was to investigate the prognostic significance of VETC in patients with recurrent early-stage HCC after repeat hepatic resection (RHR) or radiofrequency ablation (RFA). Methods. From December 2005 to December 2016, 138 patients who underwent RHR and 188 patients who underwent RFA were enrolled. VETC was evaluated by immunohistochemical staining for CD34. The survival outcomes of treatment for patients with or without the VETC pattern was investigated. Results. Among VETC-positive HCC patients, 50 patients underwent RHR, and 69 patients underwent RFA; among VETC-negative HCC patients, 88 patients underwent RHR, and 119 patients underwent RFA. There was no significant difference between the RHR and RFA groups in disease-free survival (DFS) or overall survival (OS) as determined by univariate analysis of the whole cohort. In the subgroup analysis of the VETC-positive cohort, the patients in the RHR group had a longer median DFS time compared to those in the RFA group (15.0 vs 5.0 months, P=0.001). Similarly, the patients in the RHR group had a longer median OS time compared to those in the RFA group (39.5 vs 19 months, P=0.001). In the VETC-negative cohort, there was no significant difference in DFS and OS rates between the RHR and RFA groups (P>0.05).Conclusions. The results of our study suggested that RHR was relatively safe and superior to RFA in improving survival outcomes for recurrent early-stage HCC after initial hepatectomy. Furthermore, the VETC pattern may represent a reliable marker for selecting HCC patients who may benefit from RHR.

Development and Validation of a Novel Nomogram for Predicting Vessels that Encapsulate Tumor Cluster in Hepatocellular Carcinoma

“…7 In addition, VETC pattern may represent a reliable marker for selecting recurrent early-stage HCC patients who may benefit from repeat hepatic resection. 8 Notably, it is suggested that the VETC pattern is associated with the effect of sorafenib treatment for HCC patients. Vessels that encapsulate tumor cluster-positive HCC patients may have a better prognosis than that of VETC-negative HCC patients when treated with sorafenib.…”

The presence of vessels encapsulating tumor clusters is associated with an immunosuppressive tumor microenvironment in hepatocellular carcinoma

“…Several reports have shown that VETC is an independent risk factor for poor prognosis in HCC, and patients with VETC type HCC (VETC+ HCC) exhibit shorter OS and disease free survival (DFS) and are more prone to progression and metastasis relative to patients without VETC (VETC− HCC) 2,3 . Moreover, the combination of VETC and other factors can help to predict prognosis under different HCC scenarios.…”

“…1 Several reports have shown that VETC is an independent risk factor for poor prognosis in HCC, and patients with VETC type HCC (VETC+ HCC) exhibit shorter OS and disease free survival (DFS) and are more prone to progression and metastasis relative to patients without VETC (VETCÀ HCC). 2,3 Moreover, the combination of VETC and other factors can help to predict prognosis under different HCC scenarios. In patients who underwent liver transplantation for HCC, the combination of VETC with pathologically evaluated immune status enabled further classification of patients based on their clinical outcome.…”