title: Vascular invasion affects survival in early hepatocellular carcinoma.
abstract: Hepatocellular carcinoma (HCC) is an aggressive malignant tumor with a high mortality rate. The optimal therapeutic choice for early HCC is surgical resection. However, the rate of intrahepatic recurrence is high. The objective of this study was to evaluate the effect of various factors on the survival of patients with early HCC. Between January 1st, 2006 and December 31st, 2013, a total of 89 patients who underwent surgery for HCC were retrospectively enrolled. The analysis was conducted using the Student's t-test, Chi-square test, Kaplan-Meier method and Cox proportional hazard regression model to assess potential confounding and predictive variables. The 3-year overall survival (OS) rate was 71%. The 3-year OS rates in patients with and those without vascular invasion were 62.1 and 92.8%, respectively (P<0.003). Based on the multivariate analysis, postoperative pathological vascular invasion (hazard ratio = 4.96; 95% confidence interval: 1.55-15.9) remained an independent predictor of adverse long-term outcome. Furthermore, vascular invasion was significantly associated with intrahepatic metastasis. These data emphasize the need for effective adjuvant therapy in selected high-risk patients with early HCC. Further studies are required to determine the optimal approach to further improving the prognosis of early HCC.
authors.affiliation: Department of Radiation Oncology, Far Eastern Memorial Hospital, New Taipei City 220; Taiwan, R.O.C. ; Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, Taipei City 112; Taiwan, R.O.C.
authors.forename: Chen-Hsi
authors.initials: CH
authors.lastname: Hsieh
authors.affiliation: Departments of General Surgery and Buddhist Dalin Tzu Chi Hospital, Dalin, Chiayi 62247, Taiwan, R.O.C.
authors.forename: Chang-Kuo
authors.initials: CK
authors.lastname: Wei
authors.affiliation: Departments of General Surgery and Buddhist Dalin Tzu Chi Hospital, Dalin, Chiayi 62247, Taiwan, R.O.C.
authors.forename: Wen-Yao
authors.initials: WY
authors.lastname: Yin
authors.affiliation: Departments of General Surgery and Buddhist Dalin Tzu Chi Hospital, Dalin, Chiayi 62247, Taiwan, R.O.C.
authors.forename: Chun-Ming
authors.initials: CM
authors.lastname: Chang
authors.affiliation: Departments of Radiation Oncology, Buddhist Dalin Tzu Chi Hospital, Dalin, Chiayi 62247, Taiwan, R.O.C.
authors.forename: Shiang-Jiun
authors.initials: SJ
authors.lastname: Tsai
authors.affiliation: School and Graduate Institute of Physical Therapy, College of Medicine, Taiwan, R.O.C. ; Physical Therapy Center, National Taiwan University Hospital, Taipei City 100, Taiwan, R.O.C.
authors.forename: Li-Ying
authors.initials: LY
authors.lastname: Wang
authors.affiliation: Departments of Radiation Oncology, Buddhist Dalin Tzu Chi Hospital, Dalin, Chiayi 62247, Taiwan, R.O.C.
authors.forename: Wen-Yen
authors.initials: WY
authors.lastname: Chiou
authors.affiliation: Departments of Radiation Oncology, Buddhist Dalin Tzu Chi Hospital, Dalin, Chiayi 62247, Taiwan, R.O.C. ; School of Medicine, Tzu Chi University, Hualien 970, Taiwan, R.O.C.
authors.forename: Moon-Sing
authors.initials: MS
authors.lastname: Lee
authors.affiliation: Departments of Radiation Oncology, Buddhist Dalin Tzu Chi Hospital, Dalin, Chiayi 62247, Taiwan, R.O.C. ; Departments of Radiation Oncology, Buddhist Dalin Tzu Chi Hospital, Dalin, Chiayi 62247, Taiwan, R.O.C.
authors.forename: Hon-Yi
authors.initials: HY
authors.lastname: Lin
authors.affiliation: Departments of Radiation Oncology, Buddhist Dalin Tzu Chi Hospital, Dalin, Chiayi 62247, Taiwan, R.O.C. ; School of Medicine, Tzu Chi University, Hualien 970, Taiwan, R.O.C.
authors.forename: Shih-Kai
authors.initials: SK
authors.lastname: Hung
keywords: hepatocellular carcinoma; surgery; vascular invasion