How to Predict Recurrence After Resection of Hepatocellular Carcinoma

Anticancer Res. 2025 Jan;45(1):189-199. doi: 10.21873/anticanres.17404.

Abstract

Background/aim: Predictors of recurrence following resection of hepatocellular carcinoma (HCC) are not fully established. This study investigated potential risk factors and prognostic scores for this situation.

Patients and methods: In 297 patients undergoing resection of HCC between 2000 and 2021, risk scores and potential additional risk factors for intrahepatic and extrahepatic recurrence were assessed.

Results: Median overall survival was 48.4 months, median time to recurrence 25.1 months. The Alpha-Fetoprotein (AFP)-score differentiated between low and high-risk groups (21.8 vs. 8.3 months, p=0.001), as did the Risk Estimation of Tumor Recurrence After Transplant (RETREAT)-score (16 vs. 9 months, p=0.004) and the Clinical Risk Score (CRS) (14.9 vs. 3.9 months, p=0.002). Advanced T-stage, multiple lesions, and vessel infiltration were significantly associated with any type of recurrence, advanced T-stage, and multiple lesions with intrahepatic recurrence.

Conclusion: Predictors of recurrence following resection of HCC were identified. Prognostic scores traditionally used for patients receiving liver transplantation (AFP-score, RETREAT-score, CRS) were predictive also of recurrence after resection of HCC.

Keywords: Hepatocellular carcinoma; prognostic score; recurrence; surgcal resection.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Hepatocellular* / mortality
  • Carcinoma, Hepatocellular* / pathology
  • Carcinoma, Hepatocellular* / surgery
  • Female
  • Hepatectomy / adverse effects
  • Humans
  • Liver Neoplasms* / mortality
  • Liver Neoplasms* / pathology
  • Liver Neoplasms* / surgery
  • Liver Transplantation / adverse effects
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local* / pathology
  • Neoplasm Staging
  • Prognosis
  • Risk Factors
  • alpha-Fetoproteins / analysis
  • alpha-Fetoproteins / metabolism

Substances

  • alpha-Fetoproteins