Prognostic value of tumor budding in hepatocellular carcinoma patients with negative microvascular invasion and evaluation of postoperative adjuvant therapy efficacy
YANG Kai-bo
JIA Fei
YANG Ze-rong
TANG Zhuo-ren
WU Kun-jin
WAN Yong
CHANG Hu-lin
QU Kai
Abstract：Objective To evaluate the prognostic value of tumor budding(TB)in patients with microvascular invasion(MVI)negative hepatocellular carcinoma(HCC)and to explore the impact of postoperative adjuvant therapy with tyrosine kinase inhibitors(TKI)and prophylactic transarterial chemoembolization(TACE)on the prognosis of TB-positive patients.Methods A retrospective analysis was conducted on the clinical data of 186 MVI-negative HCC patients who underwent curative surgery at the First Affiliated Hospital of Xi'an Jiaotong University,the Second Affiliated Hospital of Xi'an Jiaotong University,and Shaanxi Provincial People's Hospital between 2016 and 2020.TB was assessed through pathological and immunohistochemical examinations.The Cox proportional hazards model was used to analyze prognostic factors,and Kaplan-Meier survival curves were employed to compare the survival benefits of postoperative adjuvant therapies in the TB-positive subgroup.Follow-up was conducted until June 1,2022.Results Among the patients,85(45.6％)were TB-positive.Multivariate Cox regression analysis revealed that tumor T stage(HR=1.617,95％CI 1.157-2.260,P=0.005),preoperative AFP levels＞400 μg/L(HR=2.255,95％CI 1.294-3.928,P=0.004),and tumor diameter＞5 cm(HR=3.529,95％CI 1.311-9.411,P=0.011)were independent risk factors for overall survival(OS).TB positivity(HR=2.763,95％CI 1.687-4.526,P＜0.001),tumor multiplicity(HR=7.031,95％CI 1.751-28.229,P=0.006),and tumor diameter＞5 cm(HR=2.748,95％CI 1.343-5.623,P=0.06)were independent risk factors for recurrence-free survival(RFS).The subgroup analysis of TB-positive patients indicated that postoperative treatment with TKI and prophylactic TACE did not improve RFS or OS.Conclusion TB serves as an independent prognostic indicator for assessing recurrence risk in MVI-negative hepatocellular carcinoma patients and an important supplement to MVI.For TB-positive patients,the current postoperative adjuvant treatment strategies(TKI/TACE)did not demonstrate a significant improvement in prognosis,highlighting the need for exploring treatment strategies with better target abilities.
Keywords：hepatocellular carcinomatumor buddingmicrovascular invasiontyrosine kinase inhibitorstransarterial chemoembolization
Publication Date：2025-04-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：7( 450-456 )