Predictors of microvascular invasion before hepatectomy for hepatocellular carcinoma
Article first published online: 1 JUN 2010
Copyright © 2010 Wiley-Liss, Inc.
Journal of Surgical Oncology
Volume 102, Issue 5, pages 462–468, 1 October 2010
How to Cite
Kaibori, M., Ishizaki, M., Matsui, K. and Kwon, A.-H. (2010), Predictors of microvascular invasion before hepatectomy for hepatocellular carcinoma. J. Surg. Oncol., 102: 462–468. doi: 10.1002/jso.21631
- Issue published online: 1 JUN 2010
- Article first published online: 1 JUN 2010
- Manuscript Accepted: 22 APR 2010
- Manuscript Received: 20 OCT 2009
- liver cancer;
- microvascular invasion;
Background and Objectives
Microvascular invasion (MVI) is difficult to detect before resection of hepatocellular carcinoma (HCC).
Clinicopathological and outcome data were retrospectively compared between 213 HCC patients with MVI and 221 patients without MVI who underwent hepatectomy.
MVI risk was selected as an independent prognostic indicator for both disease-free and overall survival in our 434 HCC patients. Univariate and multivariate analyses showed that an age under 65 years, a protein induced by vitamin K absence/antagonism II (PIVKA-II) level ≥200 mAU/ml, a preoperative tumor size ≥5.0 cm, and poorly differentiated carcinoma were independent predictors of MVI. When age, PIVKA-II level, and tumor size (data available before surgery) were scored as a combined index, the total score demonstrated a significant correlation with the extent of vascular invasion and with survival after hepatic resection.
An age under 65 years, increase of PIVKA-II, and larger tumor size were preoperative predictors of MVI in HCC patients undergoing potentially curative resection. Our combined score based on the age, serum PIVKA-II, and preoperative tumor size is a reliable predictor of MVI and survival in patients with HCC. J. Surg. Oncol. 2010;102:462–468. © 2010 Wiley-Liss, Inc.