Vascular invasion affects survival in early hepatocellular carcinoma

Abstract

Abstract. Hepatocellular carcinoma (HCC) is an aggressive malignant tumor with a high mortality rate. The optimal therapeutic choice for early HCC is surgical resection. However, the rate of intrahepatic recurrence is high. The objective of this study was to evaluate the effect of various factors on the survival of patients with early HCC. Between January 1st, 2006 and December 31st, 2013, a total of 89 patients who underwent surgery for HCC were retrospectively enrolled. The analysis was conducted using the Student's t-test, Chi-square test, Kaplan-Meier method and Cox proportional hazard regression model to assess potential confounding and predictive variables. The 3-year overall survival (OS) rate was 71%. The 3-year OS rates in patients with and those without vascular invasion were 62.1 and 92.8%, respectively (P<0.003). Based on the multivariate analysis, postoperative pathological vascular invasion (hazard ratio = 4.96; 95% confidence interval: 1.55-15.9) remained an independent predictor of adverse long-term outcome. Furthermore, vascular invasion was significantly associated with intrahepatic metastasis. These data emphasize the need for effective adjuvant therapy in selected high-risk patients with early HCC. Further studies are required to determine the optimal approach to further improving the prognosis of early HCC.

The power of tumor sizes in predicting the survival of solitary hepatocellular carcinoma patients

“…Vascular invasion has been considered an important prognostic indicator in HCC . However, based on this study, no prognostic ability for vascular invasion was found in the whole population.…”

“…Numerous factors have been identified as prognostic indicators and are incorporated into various staging systems. These factors include lesion numbers, vascular invasion, portal hypertension, regional lymph node metastases, distant metastases, laboratory examination indicators such as serum albumin and bilirubin, and so on. Tumor size has been included in several staging systems, such as the Liver Cancer Study Group of Japan TNM staging system and the Hong Kong staging system .…”

Prognostic value and preoperative predictors of microvascular invasion in solitary hepatocellular carcinoma ≤ 5 cm without macrovascular invasion

“…Cai et al investigated that the 5-year overall survival and recurrence-free survival rates were 77.7% and 59.9% in small HCC patients (maximum tumor size ≤ 3 cm) after resection [ 3 ]. Tumor size, vascular invasion, histological grade and treatment strategy have been considered to be independent risk factors influencing the prognosis of early-stage HCC [ 12 – 14 ]. In the present research, we identified a total of 233 early-stage HCC patients (solitary tumor, tumor size ≤ 5 cm and no macrovascular invasion).…”

Nomogram for Individualized Prediction of Hepatocellular Carcinoma with Portal Vein Tumor Thrombosis on Conservative Treatment

“…PVTT can cause intrahepatic or distant metastasis through the portal system and lead to liver dysfunction and portal hypertension, leading to ascites formation, variceal rupture, hepatic encephalopathy, and/or death [6]. PVTT is an independent predictor of tumor recurrence and is widely accepted as a sign of advanced stage, which frequently leads to a poor prognosis [7,8]. PVTT has categorized into five grades: Vp0, no PVTT; Vp1, distal to the second-order branches; Vp2, in the second-order branches; Vp3, in the right first-order branches; and Vp4, in the main trunk or left first-order branches (or both) ( e Liver Cancer Study Group of Japan) [9].…”