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Annals of Surgical Oncology
Erschienen in: Annals of Surgical Oncology 5/2019

20.02.2019 | Hepatobiliary Tumors

Prognostic and Therapeutic Implications of Microvascular Invasion in Hepatocellular Carcinoma

verfasst von: Derek J. Erstad, MD, Kenneth K. Tanabe, MD

Erschienen in: Annals of Surgical Oncology | Ausgabe 5/2019

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Abstract

Hepatocellular carcinoma (HCC) is a morbid condition for which surgical and ablative therapy are the only options for cure. Nonetheless, over half of patients treated with an R0 resection will develop recurrence. Early recurrences within 2 years after resection are thought to be due to the presence of residual microscopic disease, while late recurrences > 2 years after resection are thought to be de novo metachronous HCCs arising in chronically injured liver tissue. Microvascular invasion (MVI) is defined as the presence of micrometastatic HCC emboli within the vessels of the liver, and is a critical determinant of early recurrence and survival. In this review, we summarize the pathogenesis and clinical relevance of MVI, which correlates with adverse biological features, including high grade, large tumor size, and epithelial–mesenchymal transition. Multiple classification schemas have been proposed to capture the heterogeneous features of MVI that are associated with prognosis. However, currently, MVI can only be determined based on surgical specimens, limiting its clinical applicability. Going forward, advances in axial imaging technologies, molecular characterization of biopsy tissue, and novel serum biomarkers hold promise as future methods for non-invasive MVI detection. Ultimately, MVI status may be used to help clinicians determine treatment plans, particularly with respect to surgical intervention, and to provide more accurate prognostication.
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Metadaten
Titel
Prognostic and Therapeutic Implications of Microvascular Invasion in Hepatocellular Carcinoma
verfasst von
Derek J. Erstad, MD
Kenneth K. Tanabe, MD
Publikationsdatum
20.02.2019
Verlag
Springer International Publishing
Erschienen in
Annals of Surgical Oncology / Ausgabe 5/2019
Print ISSN: 1068-9265
Elektronische ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-019-07227-9

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