Prognostic factors for hepatocellular carcinoma recurrence

Abstract

The recurrence of hepatocellular carcinoma, the sixth most common neoplasm and the third leading cause of cancer-related mortality worldwide, represents an important clinical problem, since it may occur after both surgical and medical treatment. The recurrence rate involves 2 phases: an early phase and a late phase. The early phase usually occurs within 2 years after resection; it is mainly related to local invasion and intrahepatic metastases and, therefore, to the intrinsic biology of the tumor. On the other hand, the late phase occurs more than 2 years after surgery and is mainly related to de novo tumor formation as a consequence of the carcinogenic cirrhotic environment. Since recent studies have reported that early and late recurrences may have different risk factors, it is clinically important to recognize these factors in the individual patient as soon as possible. The aim of this review was, therefore, to identify predicting factors for the recurrence of hepatocellular carcinoma, by means of invasive and non-invasive methods, according to the different therapeutic strategies available. In particular the role of emerging techniques (e.g., transient elastography) and biological features of hepatocellular carcinoma in predicting recurrence have been discussed. In particular, invasive methods were differentiated from non-invasive ones for research purposes, taking into consideration the emerging role of the genetic signature of hepatocellular carcinoma in order to better allocate treatment strategies and surveillance follow-up in patients with this type of tumor.

Predisposing factors for hepatocellular carcinoma recurrence following initial remission after transcatheter arterial chemoembolization

“…The fi ndings of the present study demonstrated an inverse association between tumor number and DFS time following initial TACE. Consistent with the present study, several previous studies have identified tumor number as a predictor of intrahepatic recurrence following initial TACE for HCC (27)(28)(29)(30)(31). Recurrence following initial remission by TACE has been more often reported in patients with multinodular-type HCC and with portal vein thrombosis (32).…”

Association between Loss of Skeletal Muscle Mass and Mortality and Tumor Recurrence in Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis

“…HCC has the third highest mortality rate worldwide, with the 5-year survival rate ranging from 10 to 28% [2,3]. Multiple factors are associated with clinical outcomes of HCC, including liver function, tumor site, treatment type, and comorbidity [4,5]. Early detection and referral for curative treatments such as surgical resection and radiofrequency ablation are the most effective approaches to increase the survival of patients.…”

HepPar1-Positive Circulating Microparticles are Increased in Subjects with Hepatocellular Carcinoma and Predict Early Recurrence after Liver Resection

“…For this reason, survival rate is only 30-50% over the same period of time [5,6]. When HCC recurs more than 2 years after LR, this is mainly due to the emergence of new neoplastic lesions, as a consequence of the carcinogenic environment of the remnant liver [7][8][9]. However, recurrence after LR may occur earlier (within 2 years).…”