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ASCOBT 2023: Does Postoperative Microvascular Invasion Impact Outcomes in Hepatocellular Carcinoma?

By: Julia Fiederlein Cipriano, MS
Posted: Friday, August 18, 2023

A retrospective analysis conducted by Huanwei Chen, MD, of Foshan First People’s Hospital, Guangdong, China, revealed that as the grade of postoperative pathologic microvascular invasion rises in patients with hepatocellular carcinoma, prognostic outcomes become increasingly unfavorable. The results, which were presented during the 2023 American Society of Clinical Oncology (ASCO) Breakthrough meeting (Abstract 52) in Yokohama, Japan, also highlighted the long-term prognostic superiority of wide versus narrow margin resection in those with microvascular invasion. 

The study focused on 513 patients who underwent hepatectomy. Based on a univariate analysis, tumor diameter, tumor number, China liver cancer stage, and alpha-fetoprotein levels were risk factors for microvascular invasion. A multivariate analysis revealed that tumor maximum diameter, tumor number, and China liver cancer stage were independent influencing factors.

The incidence of postoperative complications did not seem to significantly differ among the microvascular invasion grade groups. The 1-, 2-, and 3-year rates of disease-free and overall survival were found to be significantly higher in patients with M0 versus M1 and M2 microvascular invasion.

In patients with microvascular invasion–negative disease, wide versus narrow margin resection resulted in numerically higher disease-free survival rates at 1 (82.6% vs. 79.4%), 2 (70.7% vs. 64.7%), and 3 (65.4% vs. 60.5%) years; wide margin resection also yielded numerically higher overall survival rates (at 1 year: 97.5% vs. 97.1%; at 2 years: 89.6% vs. 86.0%; at 3 years: 85.2% vs. 82.8%). In patients with microvascular invasion–positive disease, wide versus narrow margin resection demonstrated significantly higher disease-free survival rates at 1 year (58.1% vs. 42.9%), at 2 years (45.4% vs. 37.3%), and at 3 years (40.3% vs. 36.1%) years; additionally, those who underwent wide margin resection experienced significantly higher overall survival rates (at year 1: 88.8% vs. 82.6%; at year 2: 71.9% vs. 64.8%; at year 3: 64.3% vs. 61.0%).

Disclosure: The study author reported no conflicts of interest.

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