Risk factors of microvascular invasion, portal vein tumor thrombosis and poor post-resectional survival in HBV-related hepatocellular carcinoma.

Background/aims: Microvascular invasion (MVI) and portal vein tumor thrombosis (PVTT) associated factors in hepatocellular carcinoma (HCC) were previously shown. However, those for HBV-related HCC remain unknown. This study aimed to investigate the risk factors of MVI, PVTT and poor prognosis in this type of HCC.

Methodology: Consecutive 130 patients with HBV-related HCC were enrolled. The impact of variables on MVI, PVTT and post-resectional survival was determined by uni- and multi-variate analyses.

Results: By Chi-square analysis, Edmondson-Steiner grade and tumor size were related to MVI, whereas Edmondson-Steiner grade and MVI were associated with PVTT. Logistic regression identified Edmondson-Steiner grade as the sole independent determinant of MVI, but none is significant for PVTT. Tumor size carried high sensitivity and negative predictive value in prediction of MVI. Survival estimation revealed that Edmondson-Steiner grade, tumor size, PVTT, MVI, satellite nodule, TNM stage and AFP level were prognostic for overall and disease-free survival, but only Edmondson-Steiner grade was of independent implication for both. Besides, tumor size independently predicted overall survival.

Conclusions: In HBV-related HCC, differentiation degree might play an important role in vascular involvement, tumor size might be helpful in primary screening of MVI, differentiation and tumor size might be particularly significant as prognostic markers.