Chinese expert consensus on the diagnosis and treatment of hepatocellular carcinoma with microvascular invasion (2024 edition).

Background: Hepatocellular carcinoma (HCC) is one of the most common malignant tumors in China. Surgical resection is the preferred treatment for HCC, but the postoperative recurrence and metastasis rates are high. Current evidence shows that microvascular invasion (MVI) is an independent risk factor for postoperative recurrence and metastasis, but there are still many controversies about the diagnosis, classification, prediction, and treatment of MVI worldwide.

Methods: Systematic literature reviews to identify knowledge gaps and support consensus statements and a modified Delphi method to develop evidence- and expert-based guidelines and finalization of the clinical consensus statements based on recommendations from a panel of experts.

Results: After many discussions and revisions, the Chinese Association of Liver Cancer of the Chinese Medical Doctor Association organized domestic experts in related fields to form the "Chinese expert consensus on the diagnosis and treatment of hepatocellular carcinoma with microvascular invasion (2024 edition)" which included eight recommendations to better guide the prediction, diagnosis and treatment of HCC patients with MVI. The MVI pathological grading criteria as outlined in the "Guidelines for Pathological Diagnosis of Primary Liver Cancer" and the Eastern Hepatobiliary Surgery Hospital (EHBH) nomogram for predicting MVI are highly recommended.

Conclusions: We present an expert consensus on the diagnosis and treatment of MVI and potentially improve recurrence-free survival (RFS) and overall survival (OS) for HCC patients with MVI.