Microvascular invasion and positive HB e antigen are associated with poorer survival after hepatectomy of early hepatocellular carcinoma: A retrospective cohort study.

Background: We aimed to identify the independent predictive factors of microvascular invasion (MVI) for curative resection of HCC and to investigate the impacts of MVI and HBeAg on long-term recurrence and survival after resection.

Methods: The clinicopathological parameters of 237 patients with HCC with MVI who underwent hepatic resection from April 2005 to November 2010 were investigated. Clinical features and factors associated with the clinical outcomes of 386 patients with HCC without MVI were used for comparison.

Results: Multivariate stepwise logistic regression analysis revealed that alpha-fetoprotein level>100μg/L, positive HBeAg, and tumour size were independent prognostic factors in patients with HCC with MVI. The overall survival (OS) of patients in the HCC with MVI group was significantly poorer compared with the HCC without MVI group (P<0.001). However, patients with HCC without MVI group exhibited a significantly better recurrence-free survival rate (RFS) (P<0.001). While the HCC with positive HBeAg group exhibited significantly lower OS compared with the HCC with negative HBeAg group (P=0.007).

Conclusions: AFP level>100μg/L, positive HBeAg, and tumour size>2cm are independent indicators of poorer prognosis for HCC with MVI. The present study confirmed that microvascular invasion itself had a negative impact on patient survival; moreover, HBeAg was an independent risk factor influencing OS, while not RFS of patients with HCC underwent hepatectomy. It is important to predict the presence of MVI before hepatic resection to determine treatment strategies.