| Summary: | Abstract Objective To evaluate the prognostic significance of microscopic bile duct invasion (MiBDI) in hepatocellular carcinoma (HCC) following R0 resection. Patients and Methods Patients who underwent R0 resection for HCC at nine medical centers were stratified into five groups: neither bile duct nor vascular invasion (MiBDI−MVI−), microscopic bile duct invasion alone (MiBDI+MVI−), both microscopic bile duct and vascular invasion (MiBDI+MVI+), microscopic vascular invasion alone (MiBDI−MVI+), and macroscopic bile duct invasion (MaBDI). Overall survival (OS) was assessed using Kaplan–Meier analysis, and independent risk factors of OS were determined using Cox proportional hazards models. Results A total of 377 HCC cases were analyzed. The OS for MiBDI+MVI‐ was similar to that of MiBDI−MVI− (p > 0.05) but better than MiBDI+MVI+, MiBDI−MVI+, and MaBDI (all p < 0.05). Multivariate analysis indicated that MiBDI was not an independent risk factor for OS, while MVI and MaBDI were. Conclusions Overall survival (OS) in patients with MiBDI was superior to those with MVI and MaBDI. Isolated MiBDI did not influence OS in patients with HCC after R0 resection.
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