Risk Factors Analysis of Vascular Invasion in Hepatocellular Carcinoma

Abstract

Objective: HCC carries a high recurrence rate after resection and transplant. This depends on the extent of vascular invasion. Preoperative detection of vascular invasion affects the management of patient and determines the prognosis. Vascular invasion may have to be looked for in tumors that  show certain risk factors. This study analyzes those risk factors.

Methodology: This retrospective observational study was carried out by retrieving data between 2017 to 2020. Tumors with more than 90% necrosis or those treated by chemoembolization were not included in this study. A total of 78 patients were included in the study. Multi-slice CT and 3 Tesla MRI were used as imaging tools. Vascular invasion was cross-tabulated against risk factors including size, location, morphology and encapsulation of tumor.

Results: Minimum age of patients was 22 and maximum 77 years with a mean age of 56.76 ± 10.857. Mean size of tumors was 7.29 ± 4.761 cms. Forty one patients (53%) showed vascular invasion in one or more branches of portal vein. Large tumors (p=0.002), multifocal tumors (p=0.040), unencapsulated tumors (p=0.001), infiltrative tumors (p=0.000) and those with raised serum AFP levels (p=0.016) were more likely to invade multiple vessels.

Conclusion: Larger size and multifocality of HCC are associated with more vascular invasion.

Keywords: Hepatocellular carcinoma; Vascular invasion; Imaging.