AHBPS
Annals of Hepato-Biliary-Pancreatic Surgerywww.ahbps.org S53
Prediction of microvascular invasion via gadoxetic acid-enhanced MRI in hepatocellular carcinoma:
The implication of planning extent of the hepatectomy
Hyeo Seong HWANG
1, Heejin BAE
2, Mi-Suk PARK
2, Dai Hoon HAN
3, Gi Hong CHOI*
,3, Kyung Sik KIM
3, Jin Sub CHOI
31
National Health Insurance Service Ilsan Hospital, Goyang, Korea
2
Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
3
Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
LV-OP-2-1
Introduction: The purpose of this study was to identify predictive factors for microvascular invasion (MVI) in hepatocellular carci- noma (HCC) using clinical factors and imaging findings of magnetic resonance imaging (MRI), to divide the patients into a subgroup with similar prognosis and finally to evaluate whether the extent of hepatectomy can affect long-term outcomes in the subgroup.
Methods: A total of 410 patients with surgically resected single HCC (≤ 5 cm) who underwent preoperative gadoxetic acid-enhanced MRI were included. Significant predictive factors for MVI were identified via univariate and multivariate analysis and used to divide the patients into low and high-risk groups. In the subgroup, long-term outcomes were analyzed after the minor versus major hepatec- tomy.
Results: Four variables were independently associated with MVI: alpha-fetoprotein ≥ 400 ng/mL (p = 0.021), tumor size ≥ 3 cm (p <
0.001), non-smooth tumor margin ( p < 0.001) and arterial peritumoral enhancement (p = 0.001). Patients with a combination of three or more factors were classified as the high-risk group (n = 103), which showed worse prognosis than the low-risk group (n = 307) ( p <
0.001). While the extent of hepatectomy was not associated with prognosis in the low-risk group, major hepatectomy significantly im- proved disease-free survival ( p < 0.011) and decreased early intrahepatic recurrence (< 2 years) (p = 0.005) than minor hepatectomy in the high-risk patients.
Conclusions: The patients who had a combination of three or more predictive factors for MVI showed worse prognosis after hepatec- tomy for HCC and major hepatectomy improved long-term outcomes in these high-risk patients.
pISSN: 2508-5778ㆍeISSN: 2508-5859
Ann Hepatobiliary Pancreat Surg 2021;25 Suppl 1:S53 https://doi.org/10.14701/ahbps.LV-OP-2-1
Corresponding Author: Gi Hong CHOI (CHOIGH@yuhs.ac) Presenter: Hyeo Seong HWANG (hyeoseong.h@gmail.com)
Copyright Ⓒ The Korean Association of Hepato-Biliary-Pancreatic Surgery
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