Tumor size does not affect overall survival of patients undergoing resection for a single hepatocellular carcinoma without microscopic vascular invasion.

Abstract

Abstract Purpose Whether tumor size affects the survival of patients undergoing liver resection (LR) for a single hepatocellular carcinoma (HCC) without microscopic vascular invasion (MVI), i.e., pathological T1N0M0, is controversial. We aimed to clarify this issue. Methods We enrolled 626 patients with HCC of pathological stage T1N0M0 of the 7th edition of American Joint Committee on Cancer staging who underwent LR between 2011 and 2021 at our institution. The overall survival (OS) of patients with T1N0M0 HCC > 5.0 cm and those with T1N0M0 HCC ≤ 5.0 cm was compared using the Kaplan–Meier estimator and log-rank test both before and after propensity score matching (PSM). Results Ninety-two (14.7%) patients had T1N0M0 HCC > 5.0 cm. The proportion of patients with cirrhosis was lower in the T1N0M0 HCC > 5.0 cm group than in the T1N0M0 HCC ≤ 5.0 cm group (16.3% vs 41.2%, p < 0.001). The former also had a lower proportion of patients showing anti-HCV positivity than the latter (17.4% vs 33.9%, p = 0.002). Five-year OS did not differ significantly between the two groups before PSM (82% vs 84%, p = 0.857) or after PSM (82% vs 92%, p = 0.274). Conclusion Tumor size did not affect the OS of patients undergoing LR for T1N0M0 HCC.