Microvascular Invasion in Small-sized Hepatocellular Carcinoma: Significance for Outcomes Following Hepatectomy and Radiofrequency Ablation

作者：Imai Katsunori^*; Yamashita Yo Ichi; Yusa Toshihiko; Nakao Yosuke; Itoyama Rumi; Nakagawa Shigeki; Okabe Hirohisa; Chikamoto Akira; Ishiko Takatoshi; Baba Hideo

来源：Anticancer Research, 2018, 38(2): 1053-1060.

DOI：10.21873/anticanres.12322

• Hepatocellular carcinoma
• radiofrequency ablation
• microvascular invasion
• predictive model
• local recurrence

Background/Aim: The significance of microvascular invasion (MVI) of hepatocellular carcinoma (HCC) after radiofrequency ablation (RFA) is unknown. Patients and Methods: We studied 149 patients with solitary small-sized HCC (<= 3 cm) who underwent hepatectomy, and developed a predictive model of MVI using independent factors related to the presence of MVI. The predictive model was applied to 159 patients who underwent RFA, and their outcomes were examined. Results: A multivariate analysis revealed that alpha-fetoprotein >= 15 ng/ml (relative risk (RR) 3.05, p=0.02), des-gamma-carboxy prothrombin >= 100 mAU/ml (RR 4.19, p=0.003), and tumor size >= 2 cm (RR 3.37, p=0.03) were independent risk factors of MVI. Among the patients who underwent RFA, the survival in patients with risk factors 2-3 was significantly worse, and local recurrence was more frequently obserbed than those with 0-1. Conclusion: When an HCC tumor is expected to display MVI, RFA may not be suitable in terms of poorer survival and local disease-control rates.

• 出版日期2018-2