Impact of microvascular invasion on clinical outcomes in hepatocellular carcinoma patients following liver transplantation

微血管侵犯对肝细胞癌患者肝移植术后临床结局的影响

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Abstract

This study aimed to investigate the influence of microvascular invasion (MVI) on the prognosis of hepatocellular carcinoma (HCC) patients after liver transplantation. We retrospectively analyzed the clinicopathological data of 130 HCC patients who underwent liver transplantation in First People's Hospital of Foshan, Foshan, China between January 2011 and October 2024. Cox regression analysis was employed to determine whether MVI is an independent prognostic factor for patient survival. Survival analysis was also performed. Among the 130 patients, 39 (30.0%) patients had MVI. Patients with MVI had significantly worse postoperative survival compared to those without MVI (P = .0486). The 1-, 3-, and 5-year survival rates for patients with MVI were 69.23%, 30.77%, and 28.21%, respectively, which were lower than those for patients without MVI (80.22%, 59.34%, and 38.46%, respectively). Additionally, patients with MVI had higher recurrence rates. The postoperative progression-free survival (PFS) of patients with MVI was also significantly worse than that of patients without MVI (P = .0309). The 1-, 3-, and 5-year PFS rates for patients with MVI were 58.97%, 23.08%, and 12.82%, respectively, compared to 69.23%, 38.46%, and 20.88% for patients without MVI. Among the 130 patients, 69 met the Milan criteria. For these patients, those with MVI had significantly worse overall survival (P = .0333) and PFS (P = .0261) compared to those without MVI. MVI is a significant prognostic factor for HCC patient survival after liver transplantation. Patients with MVI have higher recurrence rates and worse survival outcomes. Moreover, even among patients who meet the Milan criteria, those with MVI still exhibit higher recurrence rates and worse prognosis.

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