Background: The presence of microvascular invasion (McVI) in hepatocellular carcinoma (HCC) has been proposed
as a cause of recurrence and poor survival, although this has not been officially emphasized in staging systems.
Thus, we conducted a retrospective study to investigate the prognostic importance of McVI in tumor staging in
patients with HCC who underwent hepatic resection.
Methods: A retrospective analysis was performed of patients who underwent hepatic resection for HCC at our
center from 1994 to 2012. Patients with HCC were classified into four groups based on the presence of McVI and
extent of gross vascular invasion (VI).
Results: The 5-year overall and recurrence-free survival rates of 676 patients were 63.3 and 42.6%, respectively. There
was no difference in tumor recurrence or survival rate between patients with HCC and McVI without gross VI and those
with gross VI confined to segmental/sectional branches. Multivariate analysis revealed that the extent of VI based on
the presence of McVI and gross VI was independently associated with tumor recurrence and overall survival.
Conclusions: McVI was revealed to be an important risk factor similar to gross VI confined to a segmental/sectional
branch in patients with HCC who underwent hepatic resection. This finding should be considered when estimating
the stage for prognosis.