A system of classifying microvascular invasion to predict outcome after resection in patients with hepatocellular carcinoma

Sasan Roayaie ¹, Iris N Blume , Swan N Thung

⁰Mount Sinai Liver Cancer Program, Mount Sinai School of Medicine, New York, New York 10029, USA. sasan.roayaie@mountsinai.org

Gastroenterology +

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June 16, 2009

View abstract on PubMed

Summary

Microvascular invasion (mVI) in hepatocellular carcinoma (HCC) predicts recurrence after resection. Features like muscular vessel invasion and distance from the tumor can predict patient survival and recurrence risk.

Area Of Science

Hepatobiliary surgery
Oncology
Pathology

Background

Hepatocellular carcinoma (HCC) frequently recurs post-resection, with microvascular invasion (mVI) being a key risk factor.
Understanding mVI features is crucial for predicting outcomes in HCC patients.

Purpose Of The Study

To identify specific features of mVI that correlate with recurrence and survival in patients undergoing HCC resection.
To develop a novel classification system for predicting mVI risk in HCC.

Main Methods

Retrospective review of 384 HCC resections performed between 1990 and 2006.
Histologic analysis to identify mVI, recording vessel characteristics, distance from tumor, and satellite nodules.
Multivariate analysis to determine predictors of recurrence and survival.

Main Results

Of 384 patients, 131 had mVI. Invasion of a muscular vessel wall predicted recurrence (HR 1.8, P=.02).
Muscular vessel wall invasion (HR 2.2, P=.018) and invasion >1cm from tumor (HR 2.1, P=.015) predicted survival.
A risk score based on these variables correlated significantly with recurrence (P=.028) and survival (P<.0001).

Conclusions

A new classification system incorporating muscular vessel wall invasion and invasion >1cm from the tumor accurately predicts recurrence and survival in HCC patients with mVI.
This system aids in risk stratification for patients undergoing HCC resection with mVI.

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