Predictors of Microvascular Invasion Before Hepatectomy for Hepatocellular Carcinoma

Background and Objectives: Microvascular invasion (MVI) is difficult to detect before resection of hepatocellular carcinoma (HCC) Methods: Clinicopathological and outcome data were retrospectively compared between 213 HCC patients with M VI and 221 patients without MVI who underwent hepatectomy Results: M VI risk was selected as an independent prognostic indicator for both disease-free and overall survival in our 434 HCC patients Univariate and multivariate analyses showed that an age under 65 years, a protein induced by vitamin K absence/antagonism II (PIVKA-II) level >= 200 mAU/ml. a preoperative tumor size >= 5 0 cm. and poorly differentiated carcinoma were independent predictors of MVI When age. PIVKA-II level, and tumor size (data available before surgery) were scored as a combined index, the total score demonstrated a significant correlation with the extent of vascular invasion and with survival after hepatic resection Conclusions: An age under 65 years. increase of PIVKA-II. and larger tumor size were preoperative predictors of MVI in HCC patients undergoing potentially curative resection Our combined score based on the age. serum PIVKA-II. and preoperative tumor size is a reliable predictor of NI VI and survival in patients with HCC J Surg Oncol 2010,102 462-468 (C) 2010 Wiley-Liss, Inc