Grading risk of microvascular invasion impacts survival in hepatocellular carcinoma patients undergoing adjuvant...

To investigate the influence of postoperative adjuvant transarterial chemoembolization (PA-TACE) on the prognosis of hepatocellular carcinoma (HCC) patients with microvascular invasion (MVI) following liver resection (LR), and explore whether grading risk of MVI can impact the survival of HCC patients undergoing PA-TACE.

Patients who had HCC with MVI were consecutively enrolled. Overall survival (OS) and recurrence-free survival (RFS) were compared between the PA-TACE and LR groups. Univariate and multivariate analyses were performed to identify independent prognostic factors for these patients. Subgroup survival analysis was conducted using the grading risk of MVI.

The median OS and RFS of the PA-TACE group were significantly longer than the LR group. PA-TACE was associated with significantly better OS (P = 0.032) and RFS (P = 0.023) compared with LR alone. In subgroup analysis, there were no significant differences in prognosis between the PA-TACE and LR groups for HCC patients with low-risk MVI. For HCC patients with high-risk MVI, the PA-TACE group had significantly better prognosis than the LR group (for OS, P = 0.017; for RFS, P = 0.018).

PA-TACE should be performed selectively in HCC patients with high-risk MVI after curative liver resection. Nonetheless, for HCC patients with low-risk MVI, PA-TACE is not recommended.