The effect of Microvascular Invasion on Hepatocellular Carcinoma with Portal Vein Tumor Thrombus after Hepatectomy: A multicenter study

Abstract

Abstract Background There is no reported resolving whether microvascular invasion (MVI) affects the prognosis of hepatectomy for HCC patients with portal vein tumor thrombus (PVTT). The present study aimed to investigate the effect of MVI on HCC with PVTT after Hepatectomy. Methods A retrospective cohort study consisting of 362 HCC patients with PVTT was included in this study. The log-rank test was utilized to differentiate OS and RFS rates between the two groups. Univariate and multivariate Cox proportional hazard regression was utilized to detect independent factors. Results PVTT without MVI accounted for 12.2% (n = 44). PVTT without MVI groups was significantly superior to PVTT with MVI groups in OS and RFS. The 1-, 3-, and 5-year OS rates (65.5%, 36.8%, 21.7% vs. 53.5%, 18.7%, 10.1%, p = 0.014) and RFS rates (47.0%, 29.7%, 19.2% vs. 28.7%, 12.2%, 6.9%, p = 0.005) were significant differences between two groups. Multivariate analysis showed that MVI was the independent risk factor for OS and RFS. Conclusions MVI was an independent prognostic factor closely linked to tumor recurrence and poorer clinical outcomes for HCC patients with PVTT after liver resection. MVI should be included in current PVTT systems to improve the accuracy of PVTT typing.