Classification of microvascular invasion of hepatocellular carcinoma: correlation with prognosis and magnetic resonance imaging
Background/Aims The microvascular invasion (MVI) of hepatocellular carcinoma (HCC) involves a wide histological spectrum, and it is unclear whether the degree of MVI correlates with patient prognosis or imaging findings. Here, we evaluate the prognostic value of MVI classification and analyze the ra...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Korean Association for the Study of the Liver
2023-07-01
|
| Series: | Clinical and Molecular Hepatology |
| Subjects: | |
| Online Access: | http://e-cmh.org/upload/pdf/cmh-2023-0034.pdf |
| _version_ | 1797777429988638720 |
|---|---|
| author | Yoon Jung Hwang Jae Seok Bae Youngeun Lee Bo Yun Hur Dong Ho Lee Haeryoung Kim |
| author_facet | Yoon Jung Hwang Jae Seok Bae Youngeun Lee Bo Yun Hur Dong Ho Lee Haeryoung Kim |
| author_sort | Yoon Jung Hwang |
| collection | DOAJ |
| description | Background/Aims The microvascular invasion (MVI) of hepatocellular carcinoma (HCC) involves a wide histological spectrum, and it is unclear whether the degree of MVI correlates with patient prognosis or imaging findings. Here, we evaluate the prognostic value of MVI classification and analyze the radiologic features predictive of MVI. Methods Using a retrospective cohort of 506 patients with resected solitary HCCs, the histological and imaging features of MVI were reviewed and correlated with clinical data. Results MVI-positive HCCs invading ≥5 vessels or those with ≥50 invaded tumor cells were significantly associated with decreased overall survival (OS). The 5-year OS, recurrence-free survival (RFS), and beyond Milan criteria RFS rates were significantly poorer in patients with severe MVI compared with those with mild or no MVI. Severe MVI was a significant independent predictive factor for OS (odds ratio [OR], 2.962; P<0.001), RFS (OR, 1.638; P=0.002), and beyond Milan criteria RFS (OR, 2.797; P<0.001) on multivariable analysis. On MRI, non-smooth tumor margins (OR, 2.224; P=0.023) and satellite nodules (OR, 3.264; P<0.001) were independently associated with the severe-MVI group on multivariable analysis. Both non-smooth tumor margins and satellite nodules were associated with worse 5-year OS, RFS, and beyond Milan criteria RFS. Conclusions Histologic risk classification of MVI according to the number of invaded microvessels and invading carcinoma cells was a valuable predictor of prognosis in HCC patients. Non-smooth tumor margin and satellite nodules were significantly associated with severe MVI and poor prognosis. |
| first_indexed | 2024-03-12T23:03:50Z |
| format | Article |
| id | doaj.art-8be69bb183df44cf80b8de46481e286e |
| institution | Directory Open Access Journal |
| issn | 2287-2728 2287-285X |
| language | English |
| last_indexed | 2024-03-12T23:03:50Z |
| publishDate | 2023-07-01 |
| publisher | Korean Association for the Study of the Liver |
| record_format | Article |
| series | Clinical and Molecular Hepatology |
| spelling | doaj.art-8be69bb183df44cf80b8de46481e286e2023-07-19T06:44:39ZengKorean Association for the Study of the LiverClinical and Molecular Hepatology2287-27282287-285X2023-07-0129373374610.3350/cmh.2023.00341819Classification of microvascular invasion of hepatocellular carcinoma: correlation with prognosis and magnetic resonance imagingYoon Jung Hwang0Jae Seok Bae1Youngeun Lee2Bo Yun Hur3Dong Ho Lee4Haeryoung Kim5 Department of Pathology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea Department of Pathology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea Department of Radiology, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Korea Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea Department of Pathology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, KoreaBackground/Aims The microvascular invasion (MVI) of hepatocellular carcinoma (HCC) involves a wide histological spectrum, and it is unclear whether the degree of MVI correlates with patient prognosis or imaging findings. Here, we evaluate the prognostic value of MVI classification and analyze the radiologic features predictive of MVI. Methods Using a retrospective cohort of 506 patients with resected solitary HCCs, the histological and imaging features of MVI were reviewed and correlated with clinical data. Results MVI-positive HCCs invading ≥5 vessels or those with ≥50 invaded tumor cells were significantly associated with decreased overall survival (OS). The 5-year OS, recurrence-free survival (RFS), and beyond Milan criteria RFS rates were significantly poorer in patients with severe MVI compared with those with mild or no MVI. Severe MVI was a significant independent predictive factor for OS (odds ratio [OR], 2.962; P<0.001), RFS (OR, 1.638; P=0.002), and beyond Milan criteria RFS (OR, 2.797; P<0.001) on multivariable analysis. On MRI, non-smooth tumor margins (OR, 2.224; P=0.023) and satellite nodules (OR, 3.264; P<0.001) were independently associated with the severe-MVI group on multivariable analysis. Both non-smooth tumor margins and satellite nodules were associated with worse 5-year OS, RFS, and beyond Milan criteria RFS. Conclusions Histologic risk classification of MVI according to the number of invaded microvessels and invading carcinoma cells was a valuable predictor of prognosis in HCC patients. Non-smooth tumor margin and satellite nodules were significantly associated with severe MVI and poor prognosis.http://e-cmh.org/upload/pdf/cmh-2023-0034.pdfhepatocellular carcinomamicrovascular invasionprognosismagnetic resonance imaging |
| spellingShingle | Yoon Jung Hwang Jae Seok Bae Youngeun Lee Bo Yun Hur Dong Ho Lee Haeryoung Kim Classification of microvascular invasion of hepatocellular carcinoma: correlation with prognosis and magnetic resonance imaging Clinical and Molecular Hepatology hepatocellular carcinoma microvascular invasion prognosis magnetic resonance imaging |
| title | Classification of microvascular invasion of hepatocellular carcinoma: correlation with prognosis and magnetic resonance imaging |
| title_full | Classification of microvascular invasion of hepatocellular carcinoma: correlation with prognosis and magnetic resonance imaging |
| title_fullStr | Classification of microvascular invasion of hepatocellular carcinoma: correlation with prognosis and magnetic resonance imaging |
| title_full_unstemmed | Classification of microvascular invasion of hepatocellular carcinoma: correlation with prognosis and magnetic resonance imaging |
| title_short | Classification of microvascular invasion of hepatocellular carcinoma: correlation with prognosis and magnetic resonance imaging |
| title_sort | classification of microvascular invasion of hepatocellular carcinoma correlation with prognosis and magnetic resonance imaging |
| topic | hepatocellular carcinoma microvascular invasion prognosis magnetic resonance imaging |
| url | http://e-cmh.org/upload/pdf/cmh-2023-0034.pdf |
| work_keys_str_mv | AT yoonjunghwang classificationofmicrovascularinvasionofhepatocellularcarcinomacorrelationwithprognosisandmagneticresonanceimaging AT jaeseokbae classificationofmicrovascularinvasionofhepatocellularcarcinomacorrelationwithprognosisandmagneticresonanceimaging AT youngeunlee classificationofmicrovascularinvasionofhepatocellularcarcinomacorrelationwithprognosisandmagneticresonanceimaging AT boyunhur classificationofmicrovascularinvasionofhepatocellularcarcinomacorrelationwithprognosisandmagneticresonanceimaging AT dongholee classificationofmicrovascularinvasionofhepatocellularcarcinomacorrelationwithprognosisandmagneticresonanceimaging AT haeryoungkim classificationofmicrovascularinvasionofhepatocellularcarcinomacorrelationwithprognosisandmagneticresonanceimaging |