Clinical study of microvascular invasion on prognosis of recipients after liver transplantation for liver cancer
10.3969/j.issn.1674-7445.2021.03.009
- VernacularTitle:微血管侵犯对肝癌肝移植受者预后影响的临床研究
- Author:
Jianfeng WANG
1
;
Kaining ZENG
;
Haibo LI
;
Yinan DENG
;
Yingcai ZHANG
;
Tong ZHANG
;
Shuhong YI
;
Genshu WANG
;
Yang YANG
;
Guihua CHEN
Author Information
1. Department of Hepatic Surgery, Liver Transplantation Center, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China
- Publication Type:Research Article
- Keywords:
Primary liver cancer;
Liver transplantation;
Microvascular invasion (MVI);
Overall survival (OS);
Recurrence-free survival (RFS);
Alpha-fetoprotein;
Milan criteria;
Down-staging therapy
- From:
Organ Transplantation
2021;12(3):309-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the effect of microvascular invasion (MVI) on prognosis of recipients after liver transplantation for primary liver cancer (liver cancer). Methods Clinical data of 177 recipients after liver transplantation for liver cancer were retrospectively analyzed. All patients were divided into the MVI-positive group (n=64) and MVI-negative group (n=113) according to postoperative pathological examination results. Clinical data were statistically compared of all recipients between the negative and positive MVI groups. The prognosis and risk factors of liver transplantation recipients for liver cancer were analyzed. Results Among 177 recipients, 64 cases (36.2%) were positive for MVI and 113 (63.8%) negative for MVI. Compared with the MVI-negative recipients, MVI-positive recipients had significantly lower degree of tumor differentiation, higher preoperative alpha-fetaprotein (AFP) level, larger maximal tumor diameter, a larger quantity of tumors, more satellite lesions and more recipients who did not meet the Milan criteria (all P < 0.05). The 1-, 3- and 5-year overall survival (OS) and recurrence-free survival (RFS) of recipients after liver transplantation for liver cancer were 80.2%, 62.1%, 58.5% and 66.3%, 57.5%, 51.2%, respectively. The 1-, 3- and 5-year OS and RFS of MVI-positive recipients were 70%, 39%, 35% and 53%, 39%, 33%, significantly lower than 86%, 75%, 72% and 73%, 68%, 63% of their counterparts negative for MVI (all P < 0.05). Cox regression analysis showed that the maximal tumor diameter >8 cm, preoperative AFP level ≥20 ng/mL, low degree of tumor differentiation and positive MVI were the independent risk factors for OS of recipients after liver transplantation for liver cancer (all P < 0.05). Positive MVI, low degree of tumor differentiation and preoperative down-staging failure were the independent risk factors for RFS of recipients after liver transplantation for liver cancer (all P < 0.05). Conclusions MVI is of significant clinical value in predicting clinical prognosis of recipients after liver transplantation for liver cancer.
