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

Am J Surg. 2024 Dec:238:115988. doi: 10.1016/j.amjsurg.2024.115988. Epub 2024 Sep 24.

Abstract

Purpose: 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).

Methods: 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.

Results: 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.

Conclusion: 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.

Keywords: Hepatocellular carcinoma; Laparoscopic liver resection; Microvascular invasion; Recurrence; Survival.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Carcinoma, Hepatocellular* / mortality
  • Carcinoma, Hepatocellular* / pathology
  • Carcinoma, Hepatocellular* / surgery
  • Female
  • Hepatectomy*
  • Humans
  • Laparoscopy*
  • Liver Neoplasms* / mortality
  • Liver Neoplasms* / pathology
  • Liver Neoplasms* / surgery
  • Male
  • Middle Aged
  • Neoplasm Grading
  • Neoplasm Invasiveness
  • Neoplasm Recurrence, Local / epidemiology
  • Neoplasm Recurrence, Local / pathology
  • Neoplasm Staging*
  • Retrospective Studies
  • Risk Factors
  • Severity of Illness Index
  • Survival Rate
  • Treatment Outcome