Micronvasive behaviour of single small hepatocellular carcinoma: which treatment?

摘要: Microinvasion (MI), defined as infiltration of the portal or hepatic vein bile duct and intrahepatic metastasis are accurate indicators a poor prognosis for mall hepatocellular carcinomas (HCC). A previous study showed that intraoperative ultrasound (IOUS) definition MI-HCC had high concordance with histological findings. Aim this is to evaluate overall survival recurrence patterns patients submitted resection (HR) laparoscopic ablation therapies (LAT). total 171 consecutive (78 h; 93 LAT) single, small HCC (< 3 cm) MI pattern at IOUS examination were compared analyzing using univariate multivariate analysis weighting by propensity score. Overall recurrences similar in 2 groups (HR: 51 (65%); LAT: 66 (71%)). The rate local tumor progression HR group was very low (5 pts; 6%) comparison LAT (22 24%; p = 0.002). curves significantly better than (p = 0.0039). On score Cox model, mortality predicted surgical treatment Hazard ratio 1.68 (1.08–2.623) (p = 0.022). If technically feasible fit surgery, an adequate margin should be preferred evaluation, eradicate features near main nodule, which relatively frequent even (< 3 cm).