Abstract: Objective To perform the prognostic analyses and comparison of primary hepatocellular carcinoma (HCC) patients with microvascular invasion (MVI) treated by different resection margin schemes.Methods A total of 145 HCC patients who underwent radical hepatectomy from January 2016 to April 2022 in Chengdu BOE Hospital were collected, including 88 males and 57 females, with an average age of (52.7±7.8) years. According to the width of surgical margin, the patients were divided into a <1 cm group (Group A, n=99 cases) and a >1 cm group (Group B, n=46 cases). Both groups of patients were followed up for one year, and the clinical data, operative and postoperative follow-up data of these two groups of patients were compared.Results The AFP level in group A was (810.4±80.4) ng/mL, which was significantly higher than that in group B (790.1±77.3) ng/mL (P<0.05), but there was no statistical difference in age, male, BMI, virus infection, Child-Pugh grade, ICG R15, past history and clinical stage between the two groups (P>0.05). The number of blood transfusion, postoperative complications and one-year overall survival rate in group A were 19 (19.2%), 7 (7.1%) and 66 (66.7%), which were significantly lower than those of 17 (36.9%), 10 (21.7%) and 38 (82.6%) in group B, respectively (P<0.05). In group A, the tumor recurrence rates in patients with MVI and in one-year post operation were 30 (30.3%) and 58 (58.6%) cases, respectively, compared with those of 4 (8.7%) and 13 (28.3%) cases in group B, the difference was statistically significant (P<0.05).Conclusion Compared with <1 cm group, the MVI and tumor recurrence rate after radical hepatectomy in HCC patients with width >1 cm group are lower, and the overall survival situation is better, but the numbers of postoperative complications and cases of blood transfusion are higher.

Key words: Primary hepatocellular carcinoma, Microvascular invasion, Margin width, Prognosis