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World J Gastrointest Surg. Jan 27, 2023; 15(1): 19-31
Published online Jan 27, 2023. doi: 10.4240/wjgs.v15.i1.19
Postoperative adjuvant therapy for hepatocellular carcinoma with microvascular invasion
Jiang Li, Fan Yang, Jian Li, Zhi-Yong Huang, Qi Cheng, Er-Lei Zhang
Jiang Li, Jian Li, Zhi-Yong Huang, Qi Cheng, Er-Lei Zhang, Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
Jiang Li, Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, College of Medicine, Shihezi University, Shihezi 832000, Xinjiang Uygur Autonomous Regions, China
Fan Yang, Department of General Surgery, Affiliated Hospital of Hubei Minzu University, Enshi 445000, Hubei Province, China
Author contributions: Zhang EL and Cheng Q contributed to the study design, Zhang EL and Cheng Q as the co-corresponding author of this manuscript; Li J, Yang F, and Li J contributed to the collection of the data; Li J and Huang ZY contributed to the analysis and interpretation of the data and the writing of the article; Zhang EL contributed to the financial support; Cheng Q and Zhang EL contributed to the revision of the article and statistical analysis; and all authors read and approved the final version of the article.
Supported by the National Natural Science Foundation of China, No. 81902839.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Er-Lei Zhang, MD, PhD, Doctor, Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Dadao, Wuhan 430030, Hubei Province, China. baiyu19861104@163.com
Received: September 21, 2022
Peer-review started: September 21, 2022
First decision: October 18, 2022
Revised: October 29, 2022
Accepted: December 21, 2022
Article in press: December 21, 2022
Published online: January 27, 2023
Abstract

Hepatocellular carcinoma (HCC) is one of the most lethal tumors in the world. Liver resection (LR) and liver transplantation (LT) are widely considered as radical treatments for early HCC. However, the recurrence rates after curative treatment are still high and overall survival is unsatisfactory. Microvascular invasion (MVI) is considered to be one of the important prognostic factors affecting postoperative recurrence and long-term survival. Unfortunately, whether HCC patients with MVI should receive postoperative adjuvant therapy remains unknown. In this review, we summarize the therapeutic effects of transcatheter arterial chemoembolization, hepatic arterial infusion chemotherapy, tyrosine protein kinase inhibitor-based targeted therapy, and immune checkpoint inhibitors in patients with MVI after LR or LT, aiming to provide a reference for the best adjuvant treatment strategy for HCC patients with MVI after LT or LR.

Keywords: Microvascular invasion, Hepatocellular carcinoma, Liver resection, Liver transplantation, Postoperative, Adjuvant treatment

Core Tip: Microvascular invasion (MVI) is considered to be one of the important prognostic factors affecting postoperative recurrence and long-term survival. Unfortunately, whether hepatocellular carcinoma (HCC) patients with MVI should receive postoperative adjuvant therapy remains unknown. In this review, we summarize the therapeutic effects of transcatheter arterial chemoembolization, hepatic arterial infusion chemotherapy, tyrosine protein kinase inhibitor-based targeted therapy, and immune checkpoint inhibitors in patients with MVI after liver resection (LR) or liver transplantation (LT), aiming to provide a reference for the best adjuvant treatment strategy for HCC patients with MVI after LT or LR.