Liver Segment Disposition of Hepatocellular Carcinoma Predicts Microvascular Invasion

Area of Science:

• Hepatobiliary Surgery
• Surgical Oncology
• Liver Cancer Research

Background:

• Hepatocellular carcinoma (HCC) is a primary cause of cancer-related death globally.
• Microvascular invasion (MVI) in HCC patients is a key indicator of poor prognosis after surgical resection.

Purpose of the Study:

• To investigate the relationship between microvascular invasion (MVI) and hepatocellular carcinoma (HCC) within specific anatomical Couinaud's liver segments.
• To determine if HCC location within liver segments correlates with the presence of MVI and patient survival.

Main Methods:

• A multicenter retrospective analysis of 120 HCC patients who underwent liver transplantation between 2012 and 2017.
• HCC location by liver segment and MVI status were extracted from radiographic and pathology reports.
• Statistical comparison of MVI prevalence across different liver segments and survival analysis between MVI-positive and MVI-negative groups.

Main Results:

• Microvascular invasion (MVI) was identified in 23.3% of HCC explanted specimens.
• HCC tumors in liver segments 2, 3, 4b, and 5 showed a significantly higher prevalence of MVI (2-3 times greater, p=0.01).
• Patients with MVI had a significantly lower median survival (50 months) compared to those without MVI (137 months, p<0.05).

Conclusions:

• Microvascular invasion (MVI) is significantly more prevalent in HCCs located in liver segments 2, 3, 4b, and 5.
• The presence of MVI in HCC is associated with substantially reduced patient survival, underscoring its prognostic importance.