How to Predict Recurrence After Resection of Hepatocellular Carcinoma

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.