International Journal of Clinical Oncology

, Volume 23, Issue 1, pp 98–103 | Cite as

Potential predictive factors for microvascular invasion in hepatocellular carcinoma classified within the Milan criteria

  • Satoru Imura
  • Hiroki Teraoku
  • Masato Yoshikawa
  • Daichi Ishikawa
  • Shinichiro Yamada
  • Yu Saito
  • Shuichi Iwahashi
  • Tetsuya Ikemoto
  • Yuji Morine
  • Mitsuo Shimada
Original Article



Microvascular invasion (mvi) is an important risk factor for recurrent hepatocellular carcinoma (HCC), even after curative liver resection or orthotopic liver transplantation. However, mvi is difficult to detect preoperatively. The aim of this study was to clarify the risk factors of postoperative recurrence and investigate predictive factors of mvi before hepatectomy for HCC classified within the Milan criteria.


One hundred fifty-nine patients with hepatocellular carcinoma (HCC) classified within the Milan criteria, who underwent hepatectomy, were enrolled in this study. We investigated the risk factors of recurrence. In addition, we divided them into two groups: mvi-negative group and mvi-positive group, based on pathological findings after surgery. We compared the clinicopathological factors between the two groups and determined the risk factors for mvi.


Overall survival rate at 1, 3, and 5 years were 91.6%, 80.5%, and 74.9%, and the recurrence-free survival rate at 1, 3, and 5-years were 72.3%, 51.6%, and 37.2%. Risk factor analysis for tumor recurrence revealed that total bilirubin, albumin, ICGR15, AFP-L3, tumor number, mvi, and tumor stage had a significant predictive value. Multivariate analysis revealed that tumor number and mvi were significant independent risk factors for tumor recurrence. Predictive analysis for risk factors of mvi revealed that multiple tumors and AFP-L3 > 10% were significant independent risk factors for mvi in HCC classified within the Milan criteria.


The mvi was one of the independent risk factors for tumor recurrence in HCC classified within the Milan criteria. Multiple tumors and high AFP-L3 value were independent predictive factors for mvi.


Hepatocellular carcinoma Prognosis Recurrence Microvascular invasion Hepatic resection 



Retention rate of indocyanine green 15 min after administration


Lens culinaris agglutinin A-reactive fraction of α-fetoprotein


Compliance with ethical standards

Conflict of interest

The authors declare no conflict of interest.


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Copyright information

© Japan Society of Clinical Oncology 2017

Authors and Affiliations

  • Satoru Imura
    • 1
  • Hiroki Teraoku
    • 1
  • Masato Yoshikawa
    • 1
  • Daichi Ishikawa
    • 1
  • Shinichiro Yamada
    • 1
  • Yu Saito
    • 1
  • Shuichi Iwahashi
    • 1
  • Tetsuya Ikemoto
    • 1
  • Yuji Morine
    • 1
  • Mitsuo Shimada
    • 1
  1. 1.Department of SurgeryTokushima UniversityTokushimaJapan

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