Microvascular invasion (MVI) of liver cancer (MVI) MVI is an independent prognostic factor for HCC patients, which is associated with postoperative and long-term survival rates. According to a retrospective study by Shanghai Oriental Hepatobiliary Surgery Hospital, 549 cases of liver cancer were included. Among them, there were 319 cases of small liver cancer with a diameter of 5 cm and 230 cases of large liver cancer with a diameter of 5 cm. Survival analysis showed that the 1, 3, and 5-year DFS (tumor-free survival rates) of MVI(-) and MVI(+) in the small liver cancer group were %vs %. The 1, 3, and 5-year DFS (tumor-free survival rates) of MVI(-) and MVI(+) in the large liver cancer group were %vs %. Multivariate analysis showed that MVI and tumor diameter were independent influencing factors for tumor-free survival after surgery. From a pathological point of view, dissemination through the portal vein is the main route of intrahepatic metastasis, and MVI and intrahepatic metastasis are risk factors for early multinodules**. Studies have shown that MVI microvascular invasion strongly predicts intrahepatic metastases, and there are multiple nodules**, and survival rates are significantly reduced.
Hepatocellular carcinoma with MVI**.
Adequate surgical margins are an important means to reduce the postoperative rate. Compared with non-anatomical resection, anatomical excision can completely resect the portal vein branch with the tumor, which is more effective in ** intrahepatic MVI and reduces ** rate. Postoperative adjuvant TACE and oral targeted drug sorafenib may become the postoperative standard for patients with MCI for HCC and microvascular invasion**. In 2018, a study was published at ESMO to evaluate the benefit of sorafenib adjuvant** in patients with liver cancer and MVI. The cumulative RFS (no ** survival) rate and cumulative OS rate in the surgery combined with sorafenib group were higher than those in the surgery alone group, and the 1-year RFS rate increased by 511%, 3-year RFS rate increased by 321%, 1-year OS rate increased by 455%, 3-year OS rate increased by 419%, indicating that postoperative sorafenib adjuvant** can significantly prolong postoperative survival and reduce postoperative** in MVI-positive patients.
MVI and liver cancer prognosis
MVI is the leading prognostic factor in HCC and is associated with more advanced tumor stage, disease progression, local invasion, and distant metastasis. Identification of MVI is only feasible on histopathological examination of the resected surgical specimen. The incidence of MVI after surgical resection and liver transplantation ranges from 15% to 57%.
Pawlik et al. reported that MVI was at -65 and 6% and 63% in HCCs at 5 cm, respectively. Similarly, yama***a et al. also found 28MVI occurs in 9% of small liver cancers, and the 1-year** rate of patients without MVI and with MVI is 7., respectively5% and 233%。A systematic review of 20 observational studies investigating the prognostic role of MVI in people with liver transplantation or resection highlighted the adverse effects of MVI on disease-free and overall survival.
Different studies have graded MVI according to the number of invaded vessels and classified it into adhesional, infiltrative, and breakthrough types, and have found that MVI is associated with long-term survival. The distance between the embolized vessel and the main tumor is important for prognosis, and studies have shown that the 1 cm intercept** has a poor prognosis. MVI testing can help identify the risk of distant metastases after surgery and guide patients on the need for assistance**. There is an urgent need for MVI in biopsies to guide strategy.
Microvascular invasion is an important biological feature of hepatocellular carcinoma and an independent prognostic factor for early and survival after hepatectomy. The successful detection of MVI in pathology is very important, which is helpful to formulate a reasonable plan, reduce the postoperative rate, and improve the overall prognosis of patients.