Tumor Compression of the Hepatic or Portal Vein Predicts the Presence of Microvascular Invasion and Satellite Nodules in Hepatocellular Carcinoma: A Retrospective Study.

Purpose: This study aimed to evaluate the association of tumor compression in the hepatic or portal vein with the presence of microvascular invasion (MVI) and satellite nodules in patients with hepatocellular carcinoma (HCC).

Patients and methods: HCC patients at the Barcelona Clinic Liver Cancer (BCLC) stages 0-A who underwent a radical liver resection in our hospitals from January 2016 to December 2022 were collected. The tumor compression of the portal or hepatic vein in individual patients was analyzed by preoperative imaging and postoperative pathology. Their MVI, satellite nodules, overall survival (OS), and recurrence-free survival (RFS) were analyzed, and the potential risk factors for the MVI and satellite nodules of patients were analyzed by univariable and multivariable logistic analyses.

Results: A total of 390 patients were included with 333 male and 263 patients <60 years old. Of them, 51 (13.1%) HCC patients had tumor venous compression, which was not significantly associated with OS and RFS, but significantly related to higher positive rates of MVI and satellite nodules than those without tumor-venous compression (MVI, 51.0% vs 36.6%, P = 0.025; satellite nodules, 19.6% vs 9.1%, P = 0.023). Tumor venous compression was an independent risk factor for the development of MVI (OR = 1.902, 95% CI: 1.049-3.447; P = 0.034) and satellite nodules (OR = 2.871, 95% CI: 1.277-6.458; P = 0.011).

Conclusion: Preoperative tumor venous compression is an independent predictor of MVI and satellite nodules in HCC patients at BCLC stages 0-A and may serve as an imaging biomarker for determining the resection margin and treatment planning.