Abstract:Background and Aims Hepatocellular carcinoma (HCC) is a relatively common malignant tumor in China, for which, radical resection is the primary treatment option, but the postoperative recurrence still seriously affects patients' prognosis. Among various influencing factors, microvascular invasion (MVI) is considered to be an important indicator for postoperative recurrence in HCC patients. Therefore, this study was performed to investigate the risk factors for MVI in HCC patients and the impact of MVI on prognosis of patients after radical surgery, so as to provide more complete data for clinical reference.Methods The clinicopathologic data of 150 HCC patients undergoing radical surgery at Department of Hepatobiliary Surgery, the 904th Hospital of Joint Logistic Support Force of PLA from February 2017 to February 2020 were retrospectively collected. Of the patients, 42 cases had MVI and 108 cases had no MVI as identified by pathological examination. The influencing factors for MVI were analyzed by comparison of the clinical data of the two groups of patients, and the postoperative survival status of the two groups of patients was analyzed by comparing the follow-up data.Results The results of univariate analysis showed that the maximum tumor diameter, preoperative α-fetoprotein (AFP) level, and preoperative platelet (PLT) count were significantly associated with the incidence of MVI in HCC patients (all P<0.05). The results of multivariate analysis revealed that the maximum tumor diameter (>5 cm), preoperative AFP level (≥400 μg/L), and preoperative PLT count (>200×109/L) were also independent risk factors for MVI in HCC patients (all P<0.05). Follow-up was conducted in all the 150 patients for 12 to 48 months with a median time of 26 months. In patients with MVI compared with those without MVI, the 1- and 2-year overall survival rates were significantly decreased (76.19% vs. 91.67%, P<0.05, 47.20% vs.78.70%, P<0.05), and the median survival time was significantly shortened (23 months vs. 34 months, P<0.05).Conclusion The risk of MVI is increased in HCC patients with relatively large tumor size, high preoperative AFP level and high preoperative PLT count. For these patients, rigorous postoperative follow-up should be performed, so that subsequent treatment can be provided timely to improve their survival as soon as they develop signs of recurrence.