Background Hepatocellular carcinoma (HCC) is the third most common cause of cancer death worldwide, with an overall 5-year survival rate of less than 18%, which may be related to tumor microvascular invasion (MVI). This study aimed to compare the clinical prognosis of HCC patients with or without MVI after radical surgical treatment, and further analyze the preoperative risk factors related to MVI to promote the development of a new treatment strategy for HCC. Methods According to the postoperative pathological diagnosis of MVI, 160 study patients undergoing radical hepatectomy were divided into an MVI-negative group (n = 68) and an MVI-positive group (n = 92). The clinical outcomes and prognosis were compared between the two groups, and then the parameters were analyzed by multivariate logistic regression to construct an MVI prediction model. Then, the practicability and validity of the model were evaluated, and the clinical prognosis of different MVI risk groups was subsequently compared. Result There were no significant differences between the MVI-negative and MVI-positive groups in clinical baseline, hematological, or imaging data. Additionally, the clinical outcome comparison between the two groups presented no significant differences except for the pathological grading (P = 0.002) and survival and recurrence rates after surgery (P < 0.001). The MVI prediction model, based on preoperative AFP, tumor diameter, and TNM stage, presented superior predictive efficacy (AUC = 0.7997) and good practicability (high H-L goodness of fit, P = 0.231). Compared with the MVI high-risk group, the patients in the MVI low-risk group had a higher survival rate (P = 0.002) and a lower recurrence rate (P = 0.004). Conclusion MVI is an independent risk factor for a poor prognosis after radical resection of HCC. The MVI prediction model, consisting of AFP, tumor diameter, and TNM stage, exhibits superior predictive efficacy and strong clinical practicability for MVI prediction and prognostication, which provides a new therapeutic strategy for the standardized treatment of HCC patients.

Background Hepatocellular carcinoma (HCC) is the third most common cause of cancer death worldwide with an overall 5-year survival rate was less than 18%, which may be related to the tumor microvascular invasion (MVI). This study aims to compare the clinical prognosis of HCC patients with or without MVI after radical surgical treatment, and further analyze the preoperative risk factors related to MVI to detect a new treatment strategy for HCC. Methods According to postoperative pathological diagnostic of MVI occurrence, 160 study patients undergoing radical hepatectomy were divided into MVI negative group (n = 68) and MVI positive group (n = 92). The clinical outcomes and prognosis of HCC patients was compared between the two groups, and then the clinical characteristic parameters were analyzed by multivariate Logistic regression to construct a MVI prediction model. Then, the practicability and validity of the model were evaluated, and the clinical prognosis of different MVI risk groups were subsequently compared. Result There were no significant differences between the MVI negative and MVI positive group in clinical baseline, haematological and imageological data. Also, the clinical outcome comparison between the two groups presented no significant differences excepted the pathological grading (P = 0.002) and survival and recurrence rate after surgery (P < 0.001). The MVI prediction model, based on preoperative AFP, tumor diameter and TNM stage, presented superior predictive efficacy (AUC = 0.7997) and good practicability (high H-L goodness of fit, P = 0.231). Compared the MVI high-risk group, the patients in the MVI low-risk group shown higher survival rate (P = 0.002) and lower recurrence rate (P = 0.004). Conclusion MVI is an independent risk factor of HCC for poor prognosis after radical resection. The MVI prediction model, consist of AFP, tumor diameter and TNM stage, exhibits a superior predictive efficacy and strong clinical practicability for MVI prediction and prognosis estimation, which provides a new therapeutic strategy for clinical standardized treatment of HCC patients.