Grading severity of MVI impacts long-term outcomes after laparoscopic liver resection for early-stage hepatocellular carcinoma: A multicenter study

• Published in: The American journal of surgery 2024-12, Vol.238, p.115988, Article 115988
• Main Authors: Yang, Shiye, Ni, Haishun, Zhang, Aixian, Zhang, Jixiang, Liang, Huoqi, Li, Xing, Qian, Jiayi, Zang, Hong, Ming, Zhibing
• Format: Article
• Language: English
• Subjects: Adult; Aged; Body mass index; Cancer therapies; Carcinoma, Hepatocellular - mortality; Carcinoma, Hepatocellular - pathology; Carcinoma, Hepatocellular - surgery; Female; Hepatectomy; Hepatitis; Hepatocellular carcinoma; Hospitals; Humans; Hypertension; Infections; Laparoscopic liver resection; Laparoscopy; Liver; Liver cancer; Liver cirrhosis; Liver Neoplasms - mortality; Liver Neoplasms - pathology; Liver Neoplasms - surgery; Magnetic resonance imaging; Male; Microscopy; Microvascular invasion; Microvasculature; Middle Aged; Neoplasm Grading; Neoplasm Invasiveness; Neoplasm Recurrence, Local - epidemiology; Neoplasm Recurrence, Local - pathology; Neoplasm Staging; Recurrence; Regression analysis; Retrospective Studies; Risk Factors; Severity of Illness Index; Statistical analysis; Surgery; Survival; Survival Rate; Treatment Outcome; Tumors
• ISSN: 0002-9610; 1879-1883; 1879-1883
• DOI: 10.1016/j.amjsurg.2024.115988

To examine the relationship between microvascular invasion (MVI) grading severity and long-term outcomes in early-stage hepatocellular carcinoma (HCC) patients undergoing laparoscopic liver resection (LLR). Patients who had LLR for early-stage HCC were enrolled. According to the grading severity of MVI, patients were classified into M0, M1 and M2. Recurrence-free survival (RFS) and overall survival (OS) among the groups were compared. Univariate and multivariate Cox regression analyses were performed to identify independent risk factors of OS and RFS. Among 233 patients, MVI grading as M0, M1, and M2 accounts for 122 (52.4 ​%), 84 (36 ​%), and 27 (11.6 ​%) patients, respectively. The median OS and RFS in patients with M0, M1, and M2 were 84.9, 40.1, and 25.2 months; and 76.9, 27.0, and 18.8 months, respectively. Multivariable analyses identified both M1 and M2 to be independent risk factors for OS and RFS. Grading severity of MVI was independently associated with RFS and OS after LLR for early-stage HCC. Patients with MVI, especially those with M2, should receive stringent recurrence surveillance and active adjuvant therapy. •Study Highlight: Grading severity of MVI is independently associated with RFS and OS for early-stage HCC after laparoscopic liver resection.