Perivascular versus nonperivascular hepatocellular carcinoma treated with liver resection: a retrospective propensity score matching comparison of long-term outcomes

Background: The outcomes for perivascular hepatocellular carcinoma (HCC) and nonperivascular HCC after hepatectomy have not been well illustrated. This study aimed to compare long-term outcomes between perivascular and nonperivascular HCC. Methods: A total of 714 HCC patients were retrospectively collected and categorized into perivascular and nonperivascular groups according to whether the tumors had contact with branches of the portal or hepatic vein. A 1:1 propensity score matching (PSM) with a caliper of 0.02 was used to eliminate bias. Disease-free survival (DFS) and overall survival (OS) were assessed using the Kaplan-Meier method, and long-term survival analyses were conducted. Results: After PSM, 249 pairs of patients were enrolled in a nonadjacent portal vein (nPV) group and an adjacent portal vein (aPV) group. Additionally, 268 pairs of patients were enrolled in a nonadjacent hepatic vein (nHV) group and an adjacent hepatic vein (aHV) group. The aPV group had significantly worse DFS than the nPV group (5-year recurrence rates: 69.3% vs. 58.5%; P=0.008) and OS (5-year mortality: 48.6% vs. 39.0%; P=0.023). In contrast, no significant survival differences were observed between the aHV and nHV groups (DFS: P=0.980; OS: P=0.810). Multivariate analysis indicated that the tumor being adjacent to the portal vein was an independent risk factor for tumor recurrence [hazard ratio (HR) =1.374; 95% confidence interval (CI): 1.091–1.730] and overall mortality (HR =1.434; 95% CI: 1.086–1.893). Conclusions: HCC adjacent to the portal vein negatively impacted the prognosis, whereas the hepatic vein did not appear to have such an influence.