Objective:To evaluate the effect of microvascular invasion (MVI) on the postoperative prognosis of liver transplantation recipients with liver cancer.Methods:Clinical data of 78 patients with liver cancer who underwent liver transplantation in the First People's Hospital of Foshan from January 2011 to December 2021 were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. Among them, 71 patients were male and 7 female, aged (53±9) years on average. 72 cases were positive for HBsAg. Child-Pugh score was 8±2 and the model for end-stage liver disease (MELD) score was 14±7. All patients were divided into the positive (n=19) and negative MVI groups (n=59) according to postoperative pathological results. Postoperative survival of patients was compared between two groups. Survival analysis was assessed by Kaplan-Meier method and Log-rank test. The factors affecting postoperative survival were analyzed by Cox proportional hazard regression model.Results:The postoperative 1-, 3- and 5-year overall survival (OS) in the positive MVI group was 89.5%, 68.6% and 58.8%, significantly lower than 94.5%, 89.8% and 86.0% in the negative MVI group (χ2=5.495, P<0.05). In the positive MVI group, the postoperative 1-, 3- and 5-year progression-free survival (PFS) was 79.0%, 60.3% and 51.7%, significantly lower than 92.6%, 85.5% and 76.0% in the negative MVI group (χ2=3.960, P<0.05). Cox multivariate analysis showed that patients' age, Child-Pugh score, number of tumors and positive MVI were the independent influencing factors of postoperative OS (OR=0.068, 14.861, 50.102, 3.201; P<0.05). The tumor diameter and positive MVI were the independent influencing factors of postoperative PFS (OR=2.150, 2.333; P<0.05). For patients who met Milan criteria, postoperative OS and PFS in the MVI positive group were also significantly worse than those in the negative MVI group (χ2=6.013, 6.595; P<0.05).Conclusions:Positive MVI is an independent influencing factor of postoperative survival of liver cancer patients after liver transplantation. Patients positive for MVI have higher recurrence rate and worse survival compared with their negative counterparts.
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