Clinical significance of microscopic tumor venous invasion in patients with resectable hepatocellular carcinoma

• Published in: Surgery 2000-06, Vol.127 (6), p.603-608
• Main Authors: Tsai, Tzu-Jung, Chau, Gar-Yang, Lui, Wing-Yiu, Tsay, Shyh-Haw, King, Kuang-Liang, Loong, Che-Chuan, Hsia, Cheng-Yuan, Wu, Chew-Wun
• Format: Article
• Language: English
• Subjects: Aged; Carcinoma, Hepatocellular - pathology; Carcinoma, Hepatocellular - secondary; Female; Hepatic Veins - pathology; Humans; Liver Neoplasms - pathology; Male; Middle Aged; Neoplasm Invasiveness; Portal Vein - pathology
• ISSN: 0039-6060; 1532-7361
• DOI: 10.1067/msy.2000.105498

Background: Tumor venous invasion in patients with resectable hepatocellular carcinoma (HCC) is frequent and can be macroscopic and microscopic or microscopic alone. Although macroscopic invasion is a well-established prognostic indicator, the clinical significance of microscopic invasion remains unclear. Methods: There were 322 patients enrolled who had undergone curative resection for HCC. The clinicopathologic factors and prognostic significance associated with macroscopic and microscopic venous invasion were analyzed. Results: Macroscopic invasion was observed in 50 patients (15.5%) and microscopic invasion in 190 (59.0%). The larger the tumor, the more the incidence of venous invasion. There were 140 patients with microscopic invasion only (Group 1). Patients with macroscopic invasion (Group 2, n = 50) also had microscopic invasion. Compared with patients without venous invasion (Group 3, n = 132), Group 1 had a higher α-fetoprotein level, a larger tumor size, and more tumors without encapsulation. For group 1, the 1-, 3-, and 5-year disease-free survival rates were 65.6%, 41.6%, and 30.8%, respectively. The 1-, 3-, and 5-year overall survival rates were 87.8%, 60.0%, and 52.7%, respectively. The survival rates of group 1 were lower than those of group 3 and higher than those of group 2 (P