Analysis of the risk factors of tumor recurrence in hepatocellular carcinoma patients with positive microvascular invasion treated with hepatectomy

ObjectiveTo study the risk factors for tumor recurrence in hepatocellular carcinoma patients with positive microvascular invasion(MVI) treated with hepatectomy.

MethodsSixty patients with liver cancer were divided into the MVI-positive group(20 cases) and MVI-negative group(40 cases) according to the surgical pathological results.The basic data, postoperative complications, and recurrence rate and mortality after 12-month of following-up were compared between two groups.The risk factors of tumor recurrence in hepatocellular carcinoma patients with positive MVI treated with hepatectomy were analyzed.

ResultsThe differences of the gender, age, pathological type, surgical margin, anatomical hepatectomy, cirrhosis, hepatitis and liver function Child-Pugh classification between two groups were not statistically significant(P>0.05).The differences of the degree of tumor differentiation, maximum diameter of tumor, smooth edge of tumor, integrity of tumor envelope and level of α-fetoprotein(AFP) were statistically significant(P < 0.05 to P < 0.01).The postoperative complication rate in the MVI-positive group and MVI-negative group were 20.00% and 7.50%, respectively, and the difference of which between two groups was not statistically significant(P>0.05).After 12 months of following-up, the recurrence rate of tumor in MVI-positive group(25.00%) was higher that in MVI-negative group(5.00%)(P < 0.05).The difference of the mortality rate between the MVI-positive group(10.00%) and MVI-negative group(5.00%) was not statistically significant(P>0.05).The results of multivariate logistic regression analysis showed that the low differentiation, maximum diameter >5 cm, non-smooth edge, tumor-free capsule and AFP>400 g/L were the dependent risk factors of MVI-positive liver cancer(P < 0.05 to P < 0.01).

ConclusionsThe recurrence rate of MVI-positive liver cancer patients after hepatectomy is higher than that of MVI-negative liver cancer patients, and mainly related to the degree of tumor differentiation, tumor diameter, tumor margin, capsule and AFP level.