Predictive Factors of Microvascular Invasion in Patients with Hepatocellular Carcinoma Larger Than 5 Cm

Overview

Journal World J Surg

Publisher Wiley

Specialty General Surgery

Date 2008 Jul 22

PMID 18642045

Citations 20

Authors

Yasuhiko Nagano

Hiroshi Shimada

Kazuhisa Takeda

Michio Ueda

Kenichi Matsuo

Kuniya Tanaka

Itaru Endo

Chikara Kunisaki

Shinji Togo

Affiliations

Soon will be listed here.

Abstract

Background: Patients with hepatocellular carcinoma (HCC) who undergo liver resection and transplantation are predicted to have a poor outcome if the disease is associated with vascular invasion. This study aimed to identify preoperative predictors of microvascular invasion in patients with HCCs larger than 5 cm.

Methods: From May 1992 to October 2005, 231 patients underwent curative hepatic resection for HCC. Of these, 96 patients had HCCs larger than 5 cm. Analysis was limited to patients without macroscopic vascular invasion (n = 65).

Results: Multivariate analysis showed that patients with tumors larger than 7 cm and type 2 (single nodular type with extranodular growth) and type 3 (contiguous multinodular type formed by a cluster of small and contiguous nodules) tumors had an increased risk of microscopic vascular invasion. The overall incidence of microscopic vascular invasion was 46.2% (n = 30), but only 12.5% (2/16) in patients with type 1 tumors (single nodular type that is approximately round with a clear demarcation) measuring less than 7 cm.

Conclusion: Larger tumors (>7 cm) and type 2 and type 3 tumors are strong predictors of microvascular invasion in patients with HCCs larger than 5 cm.

Citing Articles

Clinical and imaging features preoperative evaluation of histological grade and microvascular infiltration of hepatocellular carcinoma.

Zhang L, Lin J, Jia M, Zhang C, Xu R, Guo L BMC Gastroenterol. 2022; 22(1):369.

PMID: 35915440 PMC: 9341046. DOI: 10.1186/s12876-022-02449-w.

A predictive and prognostic model for hepatocellular carcinoma with microvascular invasion based TCGA database genomics.

Wang J, Ding Z, Chen K, Liu Y, Li N, Hu M BMC Cancer. 2021; 21(1):1337.

PMID: 34911488 PMC: 8675478. DOI: 10.1186/s12885-021-09047-1.

Development of a novel prognostic nomogram for the early recurrence of liver cancer after curative hepatectomy.

Xia W, Peng T, Guan R, Zhou Y, Zeng C, Lin Y Ann Transl Med. 2021; 9(20):1541.

PMID: 34790747 PMC: 8576734. DOI: 10.21037/atm-21-4837.

Different Risk Factors for Early and Late Recurrence After Curative Resection of Hepatocellular Carcinoma.

Hong S, Jin X, Suh S, Hong S, Hong K, Han E World J Surg. 2021; 46(1):197-206.

PMID: 34533588 DOI: 10.1007/s00268-021-06308-9.

Sub-Classification of Cirrhosis Affects Surgical Outcomes for Early Hepatocellular Carcinoma Independent of Portal Hypertension.

Zhang E, Li J, Li J, Wang W, Gu J, Huang Z Front Oncol. 2021; 11:671313.

PMID: 34094970 PMC: 8173036. DOI: 10.3389/fonc.2021.671313.

References

Yuki K, Hirohashi S, Sakamoto M, Kanai T, Shimosato Y . Growth and spread of hepatocellular carcinoma. A review of 240 consecutive autopsy cases. Cancer. 1990; 66(10):2174-9. DOI: 10.1002/1097-0142(19901115)66:10<2174::aid-cncr2820661022>3.0.co;2-a. View

Kosuge T, Makuuchi M, Takayama T, Yamamoto J, Shimada K, Yamasaki S . Long-term results after resection of hepatocellular carcinoma: experience of 480 cases. Hepatogastroenterology. 1993; 40(4):328-32. View

Salizzoni M, Romagnoli R, Lupo F, David E, Mirabella S, Cerutti E . Microscopic vascular invasion detected by anti-CD34 immunohistochemistry as a predictor of recurrence of hepatocellular carcinoma after liver transplantation. Transplantation. 2003; 76(5):844-8. DOI: 10.1097/01.TP.0000083555.06337.8E. View

Nagano Y, Tanaka K, Togo S, Matsuo K, Kunisaki C, Sugita M . Efficacy of hepatic resection for hepatocellular carcinomas larger than 10 cm. World J Surg. 2004; 29(1):66-71. DOI: 10.1007/s00268-004-7509-y. View

Shetty K, Timmins K, Brensinger C, Furth E, Rattan S, Sun W . Liver transplantation for hepatocellular carcinoma validation of present selection criteria in predicting outcome. Liver Transpl. 2004; 10(7):911-8. DOI: 10.1002/lt.20140. View

Shimoda K, Mori M, Shibuta K, Banner B, Barnard G . Vascular endothelial growth factor/vascular permeability factor mRNA expression in patients with chronic hepatitis C and hepatocellular carcinoma. Int J Oncol. 1999; 14(2):353-9. DOI: 10.3892/ijo.14.2.353. View

Esnaola N, Lauwers G, Mirza N, Nagorney D, Doherty D, Ikai I . Predictors of microvascular invasion in patients with hepatocellular carcinoma who are candidates for orthotopic liver transplantation. J Gastrointest Surg. 2002; 6(2):224-32; discussion 232. DOI: 10.1016/s1091-255x(01)00015-4. View

Marsh J, Dvorchik I, Bonham C, Iwatsuki S . Is the pathologic TNM staging system for patients with hepatoma predictive of outcome?. Cancer. 2000; 88(3):538-43. DOI: 10.1002/(sici)1097-0142(20000201)88:3<538::aid-cncr7>3.0.co;2-h. View

Inayoshi J, Ichida T, Sugitani S, Tsuboi Y, Genda T, Honma N . Gross appearance of hepatocellular carcinoma reflects E-cadherin expression and risk of early recurrence after surgical treatment. J Gastroenterol Hepatol. 2003; 18(6):673-7. DOI: 10.1046/j.1440-1746.2003.03021.x. View

10.

Mazzaferro V, Regalia E, Doci R, Andreola S, Pulvirenti A, Bozzetti F . Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis. N Engl J Med. 1996; 334(11):693-9. DOI: 10.1056/NEJM199603143341104. View

11.

Pang A, Ng I, Fan S, Kwong Y . Clinicopathologic significance of genetic alterations in hepatocellular carcinoma. Cancer Genet Cytogenet. 2003; 146(1):8-15. DOI: 10.1016/s0165-4608(03)00103-1. View

12.

Llovet J, Bruix J, Fuster J, Castells A, Garcia-Valdecasas J, Grande L . Liver transplantation for small hepatocellular carcinoma: the tumor-node-metastasis classification does not have prognostic power. Hepatology. 1998; 27(6):1572-7. DOI: 10.1002/hep.510270616. View

13.

Roayaie S, Frischer J, Emre S, Fishbein T, Sheiner P, Sung M . Long-term results with multimodal adjuvant therapy and liver transplantation for the treatment of hepatocellular carcinomas larger than 5 centimeters. Ann Surg. 2002; 235(4):533-9. PMC: 1422469. DOI: 10.1097/00000658-200204000-00012. View

14.

Pawlik T, Delman K, Vauthey J, Nagorney D, Ng I, Ikai I . Tumor size predicts vascular invasion and histologic grade: Implications for selection of surgical treatment for hepatocellular carcinoma. Liver Transpl. 2005; 11(9):1086-92. DOI: 10.1002/lt.20472. View

15.

Izumi R, Shimizu K, Ii T, Yagi M, Matsui O, Nonomura A . Prognostic factors of hepatocellular carcinoma in patients undergoing hepatic resection. Gastroenterology. 1994; 106(3):720-7. DOI: 10.1016/0016-5085(94)90707-2. View

16.

Hui A, Takayama T, Sano K, Kubota K, Akahane M, Ohtomo K . Predictive value of gross classification of hepatocellular carcinoma on recurrence and survival after hepatectomy. J Hepatol. 2000; 33(6):975-9. DOI: 10.1016/s0168-8278(00)80131-2. View

17.

Kanai T, Hirohashi S, Upton M, Noguchi M, Kishi K, Makuuchi M . Pathology of small hepatocellular carcinoma. A proposal for a new gross classification. Cancer. 1987; 60(4):810-9. DOI: 10.1002/1097-0142(19870815)60:4<810::aid-cncr2820600417>3.0.co;2-1. View

18.

Yamanoi A, Soda Y, Yamaguchi M, Igarashi M, Yamamoto A, Nabika T . Clinical significance of microvessel density and vascular endothelial growth factor expression in hepatocellular carcinoma and surrounding liver: possible involvement of vascular endothelial growth factor in the angiogenesis of cirrhotic liver. Hepatology. 1998; 27(6):1554-62. DOI: 10.1002/hep.510270613. View

19.

Onaca N, Davis G, Goldstein R, Jennings L, Klintmalm G . Expanded criteria for liver transplantation in patients with hepatocellular carcinoma: a report from the International Registry of Hepatic Tumors in Liver Transplantation. Liver Transpl. 2007; 13(3):391-9. DOI: 10.1002/lt.21095. View

20.

Nagano Y, Togo S, Tanaka K, Matsuo K, Sugita M, Morioka D . The role of median sternotomy in resections for large hepatocellular carcinomas. Surgery. 2004; 137(1):104-8. DOI: 10.1016/j.surg.2004.03.008. View