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A non-smooth tumor margin on preoperative imaging predicts microvascular invasion of hepatocellular carcinoma

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Abstract

Purposes

Microvascular invasion (mVI) is known to be a risk factor of hepatocellular carcinoma (HCC) recurrence. Several factors such as the tumor grade, tumor size, tumor margin status on imaging studies, fluorine-18 fluorodeoxyglucose-positron emission tomography (18F-FDG-PET) results, and tumor markers have been proposed to predict mVI of HCC. However, the values of these factors have not yet been validated.

Methods

Among the patients evaluated using enhanced CT/MRI, 18F-FDG-PET, and tumor markers prior to hepatectomy from 2007 to 2012, 79 HCC patients without apparent macrovascular invasion in preoperative imaging were enrolled in this study. The image tumor margin status (smooth/non-smooth), 18F-FDG-PET, and tumor markers, which were previously described as predictors for mVI, were evaluated.

Results

Fifteen patients had mVI (mVI+ group) and 64 patients had no evidence of mVI (mVI− group) on pathological examinations. A univariate analysis showed that the mVI+ group had a higher SUV and TNR (5.2 vs 3.8, p = 0.02 and 1.8 vs 1.3, p = 0.02, respectively) and a higher portion of non-smooth tumor margin (87 vs 27 %, p = 0.0001). There was no significant difference in the tumor markers. A multivariate analysis showed that non-smooth tumor margin alone could independently predict mVI (odds ratio 18.3, 95 % CI 3.27–102.6, p = 0.0009).

Conclusion

A non-smooth tumor margin on preoperative imaging predicts microvascular invasion of HCC.

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Acknowledgments

This study was partially presented in “International Session-3 Hepato-biliary surgery” at The 115th Annual Congress of Japan Surgical Society, Nagoya (April 16–18, 2015).

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Authors and Affiliations

  1. Division of Liver and Transplantation Surgery, Department of Surgery, Chang-Gung Memorial Hospital, School of Medicine, Chang-Gung University, Taoyuan, Taiwan

    Tsung-Han Wu

  2. Department of Surgery, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Syogoin, Sakyo-ku, Kyoto, 606-8507, Japan

    Tsung-Han Wu, Etsuro Hatano, Kenya Yamanaka, Satoru Seo, Kojiro Taura, Kentaro Yasuchika, Yasuhiro Fujimoto, Takashi Nitta, Masaki Mizumoto, Akira Mori, Hideaki Okajima, Toshimi Kaido & Shinji Uemoto

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  1. Tsung-Han Wu
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Correspondence to Etsuro Hatano.

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Wu, TH., Hatano, E., Yamanaka, K. et al. A non-smooth tumor margin on preoperative imaging predicts microvascular invasion of hepatocellular carcinoma. Surg Today 46, 1275–1281 (2016). https://doi.org/10.1007/s00595-016-1320-x

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