Brian I Carr1, Vito Guerra2, Rossella Donghia2, Volkan Ince1, Sami Akbulut3, Veysel Ersan1, Sertac Usta1, Burak Isik1, Emine Samdanci4, Sezai Yilmaz1. 1. Department of Surgery, Faculty of Medicine, Liver Transplant Institute, Inonu University, Elazig Yolu 10. Km, 44280, Malatya, Turkey. 2. National Institute of Digestive Diseases. IRCCS S. de Bellis Research Hospital, Castellana Grotte, Italy. 3. Department of Surgery, Faculty of Medicine, Liver Transplant Institute, Inonu University, Elazig Yolu 10. Km, 44280, Malatya, Turkey. akbulutsami@gmail.com. 4. Department of Pathology, Faculty of Medicine, Inonu University, 44280, Malatya, Turkey.
Abstract
BACKGROUND: Microscopic portal vein invasion (microPVI) and tumor multifocality are hepatocellular carcinoma (HCC) prognosis factors. To investigate whether microPVI and multifocality are directly related to each other. METHODS: We retrospectively analyzed the relationships between microPVI, multifocality, and maximum tumor diameter (MTD) in prospectively collected transplanted HCC patients. RESULTS: HCCs with 1, 2, or ≥ 3 foci had more microPVI in larger than in smaller HCCs, with microPVI being present in 52.24% of single large foci. Conversely, microPVI patients had similar percentages of single and multifocal lesions. A linear regression model of MTD, showed microPVI best associated with MTD, with 2.49 as coefficient, whereas multifocality had a 0.83 coefficient. A logistic regression model of microPVI showed significant association with tumor multifocality, especially for small HCCs. Trends for microPVI and multifocality in relation to MTD revealed that both increased with MTD but more significantly for microPVI. Survival was similar in patients with small HCCs, with or without microPVI, but was significantly worse in microPVI patients with larger HCCs. No patient survival differences were found in relation to focality. CONCLUSIONS: MTD had stronger associations with microPVI than with multifocality. microPVI was associated with worse survival in patients with large HCCs, but survival was not impacted by number of tumor foci. microPVI and multifocality appear weakly related, having different behavior in relation to MTD and survival.
BACKGROUND: Microscopic portal vein invasion (microPVI) and tumor multifocality are hepatocellular carcinoma (HCC) prognosis factors. To investigate whether microPVI and multifocality are directly related to each other. METHODS: We retrospectively analyzed the relationships between microPVI, multifocality, and maximum tumor diameter (MTD) in prospectively collected transplanted HCC patients. RESULTS: HCCs with 1, 2, or ≥ 3 foci had more microPVI in larger than in smaller HCCs, with microPVI being present in 52.24% of single large foci. Conversely, microPVI patients had similar percentages of single and multifocal lesions. A linear regression model of MTD, showed microPVI best associated with MTD, with 2.49 as coefficient, whereas multifocality had a 0.83 coefficient. A logistic regression model of microPVI showed significant association with tumor multifocality, especially for small HCCs. Trends for microPVI and multifocality in relation to MTD revealed that both increased with MTD but more significantly for microPVI. Survival was similar in patients with small HCCs, with or without microPVI, but was significantly worse in microPVI patients with larger HCCs. No patient survival differences were found in relation to focality. CONCLUSIONS: MTD had stronger associations with microPVI than with multifocality. microPVI was associated with worse survival in patients with large HCCs, but survival was not impacted by number of tumor foci. microPVI and multifocality appear weakly related, having different behavior in relation to MTD and survival.
Authors: Brian I Carr; Vito Guerra; Edoardo G Giannini; Fabio Farinati; Francesca Ciccarese; Gian Ludovico Rapaccini; Maria Di Marco; Luisa Benvegnù; Marco Zoli; Franco Borzio; Eugenio Caturelli; Alberto Masotto; Franco Trevisani Journal: J Integr Oncol Date: 2016-09-05
Authors: Bojan Losic; Amanda J Craig; Carlos Villacorta-Martin; Sebastiao N Martins-Filho; Nicholas Akers; Xintong Chen; Mehmet E Ahsen; Johann von Felden; Ismail Labgaa; Delia DʹAvola; Kimaada Allette; Sergio A Lira; Glaucia C Furtado; Teresa Garcia-Lezana; Paula Restrepo; Ashley Stueck; Stephen C Ward; Maria I Fiel; Spiros P Hiotis; Ganesh Gunasekaran; Daniela Sia; Eric E Schadt; Robert Sebra; Myron Schwartz; Josep M Llovet; Swan Thung; Gustavo Stolovitzky; Augusto Villanueva Journal: Nat Commun Date: 2020-01-15 Impact factor: 14.919