title: Microvascular invasion has limited clinical values in hepatocellular carcinoma patients at Barcelona Clinic Liver Cancer (BCLC) stages 0 or B.
abstract: Microvascular invasion (MVI) is recognized as a prognostic factor associated with poor outcome in hepatocellular carcinoma (HCC) patients after curative resection. It remains unclear, however, whether MVI can provide prognostic information for patients at a specific tumor stage.
  
  
  
  Consecutive HCC patients who underwent curative resection in years of 2007 and 2008 (discovery cohort) were enrolled in this retrospective study. Patients were stratified by the Barcelona Clinic Liver Cancer (BCLC) staging system. The prognostic significance of MVI for overall survival (OS) and recurrence-free survival (RFS) was studied in each subgroup. The clinical significance of MVI was validated in another cohort of patients underwent curative surgery in the year of 2006 (validation cohort).
  
  
  
  Of the 1540 patients in the discovery cohort, 389 (25.3%) patients had detectable MVI. Occurrence rates of MVI in the BCLC stage 0, A, and B subgroups were 12.4, 26.2, and 34.4%, respectively. In univariate analysis, MVI was associated with poor OS and RFS (P < 0.001 for both) in HCC patients at stage A, with poor OS in patients at stage 0 (P = 0.028), and with poor RFS at stage B (P = 0.039). In multivariate analysis, MVI was an independent risk factor for OS (HR = 1.431, 95% CI, 1.163-1.761, P < 0.001) and RFS (HR = 1.400, 95% CI, 1.150-1.705, P = 0.001) in patients at stage A; and an independent risk factor for RFS (P = 0.043) in patients at stage B. A similar clinical significance of MVI was found in the validation cohort.
  
  
  
  MVI has limited prognostic value for HCC patients at BCLC stages 0 and B. For those at stage A, MVI was associated with patient survival and may help to select patients with high risk of disease recurrence.
authors.affiliation: Liver Cancer Institute and Zhongshan Hospital, Fudan University, Key Laboratory for Carcinogenesis and Cancer Invasion, the Chinese Ministry of Education, 136 Yi Xue Yuan Rd, Shanghai, 200032, China.
authors.forename: Cheng
authors.initials: C
authors.lastname: Huang
authors.affiliation: Liver Cancer Institute and Zhongshan Hospital, Fudan University, Key Laboratory for Carcinogenesis and Cancer Invasion, the Chinese Ministry of Education, 136 Yi Xue Yuan Rd, Shanghai, 200032, China.
authors.forename: Xiao-Dong
authors.initials: XD
authors.lastname: Zhu
authors.affiliation: Department of Pathology, Zhongshan Hospital, Fudan University, 136 Yi Xue Yuan Rd, Shanghai, 200032, China.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Ji
authors.affiliation: Liver Cancer Institute and Zhongshan Hospital, Fudan University, Key Laboratory for Carcinogenesis and Cancer Invasion, the Chinese Ministry of Education, 136 Yi Xue Yuan Rd, Shanghai, 200032, China.
authors.forename: Guang-Yu
authors.initials: GY
authors.lastname: Ding
authors.affiliation: Liver Cancer Institute and Zhongshan Hospital, Fudan University, Key Laboratory for Carcinogenesis and Cancer Invasion, the Chinese Ministry of Education, 136 Yi Xue Yuan Rd, Shanghai, 200032, China.
authors.forename: Guo-Ming
authors.initials: GM
authors.lastname: Shi
authors.affiliation: Liver Cancer Institute and Zhongshan Hospital, Fudan University, Key Laboratory for Carcinogenesis and Cancer Invasion, the Chinese Ministry of Education, 136 Yi Xue Yuan Rd, Shanghai, 200032, China.
authors.forename: Ying-Hao
authors.initials: YH
authors.lastname: Shen
authors.affiliation: Liver Cancer Institute and Zhongshan Hospital, Fudan University, Key Laboratory for Carcinogenesis and Cancer Invasion, the Chinese Ministry of Education, 136 Yi Xue Yuan Rd, Shanghai, 200032, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Zhou
authors.affiliation: Liver Cancer Institute and Zhongshan Hospital, Fudan University, Key Laboratory for Carcinogenesis and Cancer Invasion, the Chinese Ministry of Education, 136 Yi Xue Yuan Rd, Shanghai, 200032, China.
authors.forename: Jia
authors.initials: J
authors.lastname: Fan
authors.affiliation: Liver Cancer Institute and Zhongshan Hospital, Fudan University, Key Laboratory for Carcinogenesis and Cancer Invasion, the Chinese Ministry of Education, 136 Yi Xue Yuan Rd, Shanghai, 200032, China. sun.huichuan@zs-hospital.sh.cn.
authors.forename: Hui-Chuan
authors.initials: HC
authors.lastname: Sun
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000098:blood supply* / Q000473:pathology* / Q000601:surgery; D002648:Child; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000098:blood supply* / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D013030:Spain; D016019:Survival Analysis; D016896:Treatment Outcome; D055815:Young Adult
keywords: Barcelona Clinic Liver Cancer stage; Hepatocellular carcinoma; Microvascular invasion; Prognosis