Original CommunicationsClinical significance of microscopic tumor venous invasion in patients with resectable hepatocellular carcinoma*,**
Section snippets
Patients and methods
Between July 1991 and December 1997, there were 322 patients enrolled who had HCC and who had undergone hepatectomy at Veterans General Hospital-Taipei. These patients had the tumor tissue completely removed macroscopically. Twelve patients had a microscopic positive surgical margin on subsequent histologic examination.
There were 281 men and 41 women of mean age 60 (range, 20 to 89 years)(Table I).There were 41 patients who had received preoperative trans-catheter arterial chemoembolization,
Results
Macroscopic venous invasion was observed in 50 of the 322 patients (15.5%), and microscopic invasion was observed in 190 (59.0%). The relationship between tumor size and the percentages of macroscopic and microscopic tumor invasion is shown in Fig 1.For 37 patients with tumor size ≤2cm, one (2.7%) had macroscopic, and 15 (40.5%) had microscopic invasion. As a whole,
Discussion
In this study we found that 59.0% of the patients with HCC had either macroscopic and microscopic tumor venous invasion or microscopic tumor venous invasion alone. The larger the size of the tumor, the higher the incidence of venous invasion. Multivariate analysis showed that both macroscopic and microscopic venous invasion correlated significantly with postresectional survivals. These findings indicated that microscopic venous invasion has an important role in the HCC disease process.
In
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Supported in part by a grant from The Common Good to Surgeons Foundation (CGSF-87-24), Taipei, Taiwan, Republic of China.
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Reprint requests: Gar-Yang Chau, MD, MPH, Division of General Surgery, Department of Surgery, Veterans General Hospital-Taipei, Shih-pai, Taipei, Taiwan, 217