title: Predictive factors of microvascular invasion in patients with hepatocellular carcinoma larger than 5 cm.
abstract: BACKGROUND
  Patients with hepatocellular carcinoma (HCC) who undergo liver resection and transplantation are predicted to have a poor outcome if the disease is associated with vascular invasion. This study aimed to identify preoperative predictors of microvascular invasion in patients with HCCs larger than 5 cm.
  
  
  METHODS
  From May 1992 to October 2005, 231 patients underwent curative hepatic resection for HCC. Of these, 96 patients had HCCs larger than 5 cm. Analysis was limited to patients without macroscopic vascular invasion (n = 65).
  
  
  RESULTS
  Multivariate analysis showed that patients with tumors larger than 7 cm and type 2 (single nodular type with extranodular growth) and type 3 (contiguous multinodular type formed by a cluster of small and contiguous nodules) tumors had an increased risk of microscopic vascular invasion. The overall incidence of microscopic vascular invasion was 46.2% (n = 30), but only 12.5% (2/16) in patients with type 1 tumors (single nodular type that is approximately round with a clear demarcation) measuring less than 7 cm.
  
  
  CONCLUSIONS
  Larger tumors (>7 cm) and type 2 and type 3 tumors are strong predictors of microvascular invasion in patients with HCCs larger than 5 cm.
authors.affiliation: Gastroenterological Center, Yokohama City University Medical Center, 4-57 Urafunecho Minami-ku, Yokohama City, Japan. yasuhiko@urahp.yokohama-cu.ac.jp
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Nagano
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Shimada
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Takeda
authors.forename: Michio
authors.initials: M
authors.lastname: Ueda
authors.forename: Kenichi
authors.initials: K
authors.lastname: Matsuo
authors.forename: Kuniya
authors.initials: K
authors.lastname: Tanaka
authors.forename: Itaru
authors.initials: I
authors.lastname: Endo
authors.forename: Chikara
authors.initials: C
authors.lastname: Kunisaki
authors.forename: Shinji
authors.initials: S
authors.lastname: Togo
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D005260:Female; D006498:Hepatectomy; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D018579:Patient Selection; D011237:Predictive Value of Tests; D015996:Survival Rate; D019043:Vascular Neoplasms / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery