Diagnosis and treatment of microvascular invasion in hepatocellular carcinoma

Ke, Ruisheng; Cai, Qiucheng; Chen, Yongtai; Liu, Lizhi; Jiang, Yi

doi:10.1007/s10353-019-0573-1

Cited by 2 publications

(4 citation statements)

References 126 publications

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“…A high preoperative HBV viral DNA load in these patients was reported to be an independent risk factor of MVI. The results from the accumulated data demonstrate an important association between the use of preoperative antivirals in HBV-related HCC patients and the incidence of MVI formation and early HCC tumour recurrence (Akateh et al, 2019;Elshaarawy et al, 2019;Ke et al, 2019). Moreover, HCC patients following an antiviral treatment regimen for more than 90 days before surgery was associated with reduced incidence of MVI .…”

Section: Discussionmentioning

confidence: 97%

Preoperative antiviral therapy and microvascular invasion in hepatitis B virus-related hepatocellular carcinoma: A meta-analysis

Wang¹,

Duan

Zhang

et al. 2020

European Journal of Pharmacology

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Section: Discussionmentioning

confidence: 97%

Preoperative antiviral therapy and microvascular invasion in hepatitis B virus-related hepatocellular carcinoma: A meta-analysis

Wang¹,

Duan

Zhang

et al. 2020

European Journal of Pharmacology

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“…Unfortunately, the predictive accuracy of preoperative hematological indices is poor. As reported in the review [15], many scholars focus on a single indicator, such as tumor size, PIVKA-II level, or pure hematological/radiological indicators, to construct MVI prediction models, but unfortunately, the practicability and feasibility of these models in clinical practice remains to be further verified. In our prediction model, based on the risk factors derived from hematological data, imaging data, and clinical staging assessment, it achieved a high AUC of 0.7997 (with a sensitivity of 0.685 and specificity of 0.847) and good utility (high H-L goodness of fit, P = 0.231).…”

Section: Discussionmentioning

confidence: 99%

“…The basic clinical data were age, sex, HBV infection, liver cirrhosis, diabetes, hypertension, and smoking; the preoperative hematological data were carcinoma embryonic antigen (CEA), alpha-fetoprotein (AFP), alanine transaminase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL), albumin (ALB), and prothrombin time (PT); the preoperative imaging data were tumor diameter, number of tumors, and TNM stage (tumor stage confirmed by imaging examination). Based on the previous literature [8,15], the classification criteria for each candidate index were determined: age (< 60 years or ≥ 60 years), CEA (< 5 ng/mL or ≥ 5 ng/mL), AFP (< 400 ng/mL or ≥ 400 ng/ mL), ALT (< 40 U/L or ≥ 40 U/L), AST (< 34 U/L or ≥ 34 U/L), TBIL (< 34 mmol/L or ≥ 34 mmol/L), ALB (< 33 g/L or ≥ 33 g/L), PT (< 13 s or ≥ 13 s), tumor diameter (< 5 cm or ≥ 5 cm), number of tumors (< 2 or ≥ 3), and TNM stage (I-II, III-IV).…”

Section: Analysis Of the Clinical Characteristicsmentioning

confidence: 99%

Accurate prediction of microvascular invasion occurrence and effective prognostic estimation for patients with hepatocellular carcinoma after radical surgical treatment

et al. 2022

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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.

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“…Previous studies have indicated that anatomical liver resection is the preferred option for patients with a high suspicion of MVI ( 15 , 16 ). If patients have a low risk of MVI, local resection may be selected to reduce the risk of bleeding and infection, improving the short-term prognosis ( 17 ). Therefore, preoperative prediction, intraoperative management, and postoperative intervention for MVI have become research hotspots.…”

Section: Discussionmentioning

confidence: 99%

Effect of Microvascular Invasion on the Prognosis in Hepatocellular Carcinoma and Analysis of Related Risk Factors: A Two-Center Study

Wang

Liu

et al. 2021

Front. Surg.

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Objective: Microvascular invasion is considered to initiate intrahepatic metastasis and postoperative recurrence of hepatocellular carcinoma (HCC). We aimed to analyze the effect of MVI on the prognosis in HCC and identify related risk factors for microvascular invasion (MVI).Methods: The clinical data of 553 HCC patients who underwent liver surgery at Qingdao University from January 2014 to December 2018 and 89 patients at Beijing Tsinghua Changgung Hospital treated between October 2014 and October 2019 were collected retrospectively. We explored the impact of MVI on the prognosis of patients with HCC using Kaplan-Meier analysis. We conducted logistic regression analysis to identify variables significantly related to MVI.Results: Pathological examination confirmed the presence of MVI in 265 patients (41.3%). Six factors independently correlated with MVI were incorporated into the multivariate logistic regression analysis: Edmondson-Steiner grade [odds ratio (OR) = 3.244, 95%CI: 2.243–4.692; p < 0.001], liver capsule invasion (OR = 1.755; 95%CI: 1.215–2.535; p = 0.003), bile duct tumor thrombi (OR = 20.926; 95%CI: 2.552–171.553; p = 0.005), α-fetoprotein (> 400 vs. < 400 ng/ml; OR = 1.530; 95%CI: 1.017–2.303; p = 0.041), tumor size (OR = 1.095; 95%CI: 1.027–1.166; p = 0.005), and neutrophil-lymphocyte ratio (OR = 1.086; 95%CI: 1.016–1.162; p = 0.015). The area under the receiver operating characteristic curve (AUC) was 0.743 (95%CI: 0.704–0.781; p < 0.001), indicating that our logistic regression model had significant clinical usefulness.Conclusions: We analyzed the effect of MVI on the prognosis in HCC and evaluated the risk factors for MVI, which could be helpful in making decisions regarding patients with a high risk of recurrence.

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Diagnosis and treatment of microvascular invasion in hepatocellular carcinoma

Cited by 2 publications

References 126 publications

Preoperative antiviral therapy and microvascular invasion in hepatitis B virus-related hepatocellular carcinoma: A meta-analysis

Preoperative antiviral therapy and microvascular invasion in hepatitis B virus-related hepatocellular carcinoma: A meta-analysis

Accurate prediction of microvascular invasion occurrence and effective prognostic estimation for patients with hepatocellular carcinoma after radical surgical treatment

Effect of Microvascular Invasion on the Prognosis in Hepatocellular Carcinoma and Analysis of Related Risk Factors: A Two-Center Study

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