ArticleJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2020
Liver Resection Is Justified in Patients with BCLC Intermediate Stage Hepatocellular Carcinoma without Microvascular Invasion.
Article in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
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Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Surgical resection for large hepatocellular carcinoma and those beyond BCLC: systematic review with proposed management algorithm.Langenbeck's archives of surgery · 2023Pooled it
- A novel predictive model of microvascular invasion in hepatocellular carcinoma based on differential protein expression.BMC gastroenterology · 2023Trial
- Tumor Number and Model for End-Stage Liver Disease Score as Selection Criteria for Resection or Embolization of Intermediate-Stage Hepatocellular Carcinoma.Cancer reports (Hoboken, N.J.) · 2026Article
- Chinese expert consensus on the diagnosis and treatment of hepatocellular carcinoma with microvascular invasion (2024 edition).Hepatobiliary surgery and nutrition · 2025Review
- Preoperative prediction of microvascular invasion risk in hepatocellular carcinoma with MRI: peritumoral versus tumor region.Insights into imaging · 2024Article
- Preoperative prediction of microvascular invasion classification in hepatocellular carcinoma based on clinical features and MRI parameters.Oncology letters · 2024Article
- A Grading System of Microvascular Invasion for Patients with Hepatocellular Carcinoma Undergoing Liver Resection with Curative Intent: A Multicenter Study.Journal of hepatocellular carcinoma · 2024Article
- Hepatectomy is Beneficial in Select Patients with Multiple Hepatocellular Carcinomas.Annals of surgical oncology · 2022Article
- [Research progress of microvascular invasion in hepatocellular carcinoma].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2022Review
- Image-matching digital macro-slide-a novel pathological examination method for microvascular invasion detection in hepatocellular carcinoma.Hepatology international · 2022Article
- The priority of liver resection compared with transarterial chemoembolization in hepatocellular carcinoma at BCLC B1 stage: A single-center experience.Frontiers in surgery · 2022Article
- Microvascular Invasion in Hepatocellular Carcinoma: A Review of Its Definition, Clinical Significance, and Comprehensive Management.Journal of oncology · 2022Review
- State-of-the-art surgery for hepatocellular carcinoma.Langenbeck's archives of surgery · 2021Article
- Rethinking the Barcelona clinic liver cancer guidelines: Intermediate stage and Child-Pugh B patients are suitable for surgery?World journal of gastroenterology · 2021Review
- Liver Resection for Patients with Intermediate Stage Hepatocellular Carcinoma: Beyond Rigid Staging Systems Towards a More Personalized Therapeutic Approach.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2021Article
- The clinical significance of microvascular invasion in the surgical planning and postoperative sequential treatment in hepatocellular carcinoma.Scientific reports · 2021Article
- Prediction of Microvascular Invasion and Its M2 Classification in Hepatocellular Carcinoma Based on Nomogram Analyses.Frontiers in oncology · 2021Article
- A standardized pathological proposal for evaluating microvascular invasion of hepatocellular carcinoma: a multicenter study by LCPGC.Hepatology international · 2020Article
- Impact of Surgical Margin on the Prognosis of Early Hepatocellular Carcinoma (≤5 cm): A Propensity Score Matching Analysis.Frontiers in medicine · 2020Article
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Abstract
backgroundLarge, multinodular (> 3 nodules and/or > 3 cm) hepatocellular carcinoma (HCC) is not an indication for liver resection based on the Barcelona Clinic Liver Cancer (BCLC) staging classification. We hypothesize that microvascular invasion (MVI) is a strong indication for surgery in these patients.
methodsBetween December 2009 and December 2010, a retrospective cohort of the patients with BCLC intermediate stage HCC undergoing surgical resection at Eastern Hepatobiliary Surgery Hospital was analyzed. Propensity score matching (PSM) was conducted to balance the patients with regard to their baseline characteristics. Survival analysis was performed according to the Kaplan-Meier method. Logistic regression was conducted to identify the predictors of MVI. Risk factors were evaluated using the Cox proportional hazards model.
resultsAmong 323 patients, the MVI-negative group (26.0%) had a more favorable prognosis than did the MVI-positive group (5-year recurrence-free survival: 25.2% vs. 7.8%; 5-year overall survival: 49.5% vs. 24.0%). Similar results were identified after PSM. Compared with MVI-negative patients, MVI-positive patients experienced more early recurrence (< 2 years, P = 0.006), multinodular recurrence (P = 0.004), and extrahepatic recurrence (P = 0.026). Total bilirubin levels > 17.1 μmol/L, alpha fetal protein levels > 400 ng/mL, the presence of > 2 nodules, and the lack of a capsule were independent predictors of MVI.
conclusionsIn BCLC intermediate stage HCC, MVI predicted an adverse recurrence pattern and poor prognosis and has the potential to be used as a reference index when deciding whether to operate. Factors predictive of MVI could assist in choosing preoperative treatment and postoperative surveillance.
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