1. New predictors of microvascular invasion for small hepatocellular carcinoma ≤ 3 cm.
- Author
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Fukushima R, Harimoto N, Okuyama T, Seki T, Hoshino K, Hagiwara K, Kawai S, Ishii N, Tsukagoshi M, Igarashi T, Araki K, Tomonaga H, Higuchi T, Shimokawa M, and Shirabe K
- Subjects
- Humans, Male, Female, Middle Aged, Retrospective Studies, Aged, alpha-Fetoproteins analysis, alpha-Fetoproteins metabolism, Microvessels pathology, Prothrombin, Risk Factors, Protein Precursors, Positron Emission Tomography Computed Tomography, Neoplasm Recurrence, Local pathology, Biomarkers, Biomarkers, Tumor analysis, Hepatectomy, Tumor Burden, Carcinoma, Hepatocellular pathology, Carcinoma, Hepatocellular surgery, Liver Neoplasms pathology, Liver Neoplasms surgery, Neoplasm Invasiveness
- Abstract
Background: Microvascular invasion (MVI) is a risk factor for postoperative recurrence of hepatocellular carcinoma (HCC), even in early-stage HCC. In small HCC ≤ 3 cm, treatment options include anatomical resection or non-anatomical resection, and MVI has a major effect on treatment decisions. We aimed to identify the predictors of MVI in small HCC ≤ 3 cm., Methods: We retrospectively studied 129 patients with very early or early-stage HCC ≤ 3 cm who had undergone
18 F-fluorodeoxyglucose positron emission tomography/computed tomography and subsequent hepatic resection from January 2016 to August 2023. These patients were divided into the derivation cohort (n = 86) and validation cohort (n = 43). We examined the risk factors for MVI using logistic regression analysis, and established a predictive scoring system in the derivation cohort. We evaluated the accuracy of our scoring system in the validation cohort., Results: In the derivation cohort, a Lens culinaris agglutinin-reactive fraction of alpha-fetoprotein (AFP-L3), prothrombin induced by vitamin K deficiency or antagonist-II (PIVKA-II), and metabolic tumor volume (MTV) were independent predictors of MVI. We established the scoring system using these three factors. In the validation test, there were no MVI-positive cases with a score of 0 and 1, and all cases were MVI-positive with a score of 4. Moreover, with a score ≥ 2, the sensitivity, specificity, and accuracy of our scoring system were 100%, 71.4%, and 81.4%, respectively., Conclusions: Our scoring system can accurately predict MVI in small HCC ≤ 3 cm, and could contribute to establishing an appropriate treatment strategy., (© 2024. The Author(s) under exclusive licence to Japan Society of Clinical Oncology.)- Published
- 2024
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