{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,12]],"date-time":"2026-07-12T07:07:21Z","timestamp":1783840041813,"version":"3.55.0"},"reference-count":49,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T00:00:00Z","timestamp":1779148800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T00:00:00Z","timestamp":1779148800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Portal vein invasion is closely linked to poor prognosis in hepatocellular carcinoma (HCC). However, no study has directly compared preoperative imaging with postoperative histopathological diagnoses of portal vein invasion. This study evaluated the prognostic impact of underdiagnosed portal vein invasion in patients undergoing hepatectomy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively reviewed 1328 patients who underwent initial hepatectomy for HCC from January 2000 to December 2020. Portal vein invasion was classified as Image\u2010Vp0\u20134 based on preoperative imaging and vp0\u20134 based on postoperative pathology. Underdiagnosis was defined as IVp\u00a0&lt;\u00a0vp; otherwise, IVp\u00a0\u2265\u00a0vp. Gross invasion was defined as vp2\u20134, and non\u2010gross invasion as vp0\/1.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Pathological staging stratified overall survival (OS) more clearly than imaging (median OS: vp0\u00a0=\u00a07.9\u00a0years; vp1\u00a0=\u00a05.6; vp2\u00a0=\u00a02.5; vp3\u00a0=\u00a01.6; vp4\u00a0=\u00a00.5), while Image\u2010Vp showed less consistent trends (Vp0\u20134\u00a0=\u00a07.9; 7.6; 9.5; 1.6; 0.5\u00a0years). Underdiagnosis occurred most frequently in Image\u2010Vp0 and vp1 cases (16.7%). Patients with IVp\u00a0&lt;\u00a0vp had significantly worse OS than those with IVp\u00a0\u2265\u00a0vp (5.6 vs. 7.9\u00a0years,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001). Among vp0\/1 patients, OS was significantly shorter in underdiagnosed cases (5.8 vs. 7.9\u00a0years,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001), whereas in vp2\u20134 cases, underdiagnosis had no significant effect (3.9 vs. 1.6\u00a0years,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.317).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Underdiagnosis of vp1 was associated with significantly reduced survival in HCC patients, despite negative imaging findings. These results highlight the critical role of postoperative histopathology in accurately assessing portal vein invasion.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/wjs.70418","type":"journal-article","created":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T12:15:21Z","timestamp":1779192921000},"page":"1992-2004","source":"Crossref","is-referenced-by-count":0,"title":["Worse Prognosis of Patients With Hepatocellular Carcinoma and Portal Vein Invasion Underestimated by Imaging"],"prefix":"10.1002","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4623-1210","authenticated-orcid":false,"given":"Masanori","family":"Nakamura","sequence":"first","affiliation":[{"name":"Division of Digestive Surgery Department of Surgery Nihon University School of Medicine  Tokyo Japan"},{"name":"Department of Gastroenterological Surgery Nagoya University Graduate School of Medicine  Nagoya 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Nihon University School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiro","family":"Okada","sequence":"additional","affiliation":[{"name":"Division of Radiology Department of Radiology Nihon University School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0361-8071","authenticated-orcid":false,"given":"Shinobu","family":"Masuda","sequence":"additional","affiliation":[{"name":"Division of Human Pathology Department of Pathology and Microbiology Nihon University School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,19]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2021.11.018"},{"key":"e_1_2_13_3_1","unstructured":"National Comprehensive Cancer Network \u201cHepatocellular Carcinoma \u201d in NCCN Clinical Practice Guidelines in 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