AI Article Synopsis

  • The study aimed to identify factors influencing microvascular invasion (MVI) and prognosis in hepatocellular carcinoma (HCC) patients who underwent liver surgery.
  • A total of 1,633 surgical HCC patients were analyzed, with 754 having MVI; multivariate analysis highlighted MVI and other factors as key predictors of overall and disease-free survival.
  • Categorizing patients revealed that those with specific characteristics—hepatocirrhosis, elevated alpha-fetoprotein (AFP), larger tumor size, and a lower lymphocyte-to-monocyte ratio—were more likely to have MVI, leading to higher rates of recurrence and mortality.

Article Abstract

Objective: To investigate the influencing factors affecting the occurrence of microvascular invasion (MVI) and the prognosis of hepatocellular carcinoma (HCC) patients treated with hepatectomy, and to explore how MVI affects prognosis in subgroups with different prognostic factors.

Methods: Clinical data of a total of 1633 patients treated surgically for HCC in four treatment centers were included, including 754 patients with MVI. By using the Cox risk regression model and the Mann-Whitney U-test, the common independent influences on prognosis and MVI were made clear. The incidence of MVI in various subgroups was then examined, as well as the relationship between MVI in various subgroups and prognosis.

Results: The Cox risk regression model showed that MVI, Child-Pugh classification, alpha-fetoprotein (AFP), hepatocirrhosis, tumor diameter, lymphocyte-to-monocyte ratio (LMR), and, Barcelona clinic liver cancer (BCLC) grade were independent determinants of overall survival (OS), and MVI, AFP, hepatocirrhosis, tumor diameter, and LMR were influencing determinants for disease-free survival (DFS). The receiver operating characteristic (ROC) curve showed that MVI was most closely associated with patient prognosis compared to other prognostic factors. AFP, hepatocirrhosis, tumor diameter, and LMR were discovered to be common influences on the prognosis of patients with HCC and MVI when combined with the results of the intergroup comparison of MVI. After grouping, it was showed that patients with hepatocirrhosis, positive AFP (AFP ≥ 20 ng/mL), tumor diameter >50 mm, and LMR ≤3.4 had a significantly higher incidence of MVI than patients in other subgroups, and all four subgroups of MVI-positive patients had higher rates of early recurrence and mortality (p < 0.05).

Conclusions: MVI was found to be substantially linked with four subgroups of HCC patients with hepatocirrhosis, positive AFP, tumor diameter >50 mm, and LMR ≤3.4, and the prognosis of MVI-positive patients in all four subgroups tended to be worse.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10905528PMC
http://dx.doi.org/10.1002/cam4.6933DOI Listing

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