Review
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Feb 28, 2023; 29(8): 1243-1260
Published online Feb 28, 2023. doi: 10.3748/wjg.v29.i8.1243
Predictors of early and late hepatocellular carcinoma recurrence
Riccardo Nevola, Rachele Ruocco, Livio Criscuolo, Angela Villani, Maria Alfano, Domenico Beccia, Simona Imbriani, Ernesto Claar, Domenico Cozzolino, Ferdinando Carlo Sasso, Aldo Marrone, Luigi Elio Adinolfi, Luca Rinaldi
Riccardo Nevola, Rachele Ruocco, Livio Criscuolo, Angela Villani, Maria Alfano, Domenico Beccia, Simona Imbriani, Domenico Cozzolino, Ferdinando Carlo Sasso, Aldo Marrone, Luigi Elio Adinolfi, Luca Rinaldi, Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli,” Naples 80138, Italy
Riccardo Nevola, Ernesto Claar, Internal Medicine and Hepatology Unit, Ospedale Evangelico Betania, Naples 80147, Italy
Author contributions: Nevola R and Ruocco R contributed to the study conception and design; Nevola R, Ruocco R, Criscuolo L, Villani A, Alfano M, Beccia D and Imbriani S reviewed the literature; The first draft of the manuscript was written by Nevola R and Ruocco R; Claar E, Cozzolino D, Sasso FC, Marrone A, Adinolfi LE and Rinaldi L contributed to editing the draft and revising the manuscript for important intellectual content; All authors commented on previous versions of the manuscript, read and approved the final manuscript.
Conflict-of-interest statement: All authors report having no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Riccardo Nevola, MD, PhD, Doctor, Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli,” Piazza Miraglia, Naples 80138, Italy. riccardo.nevola@unicampania.it
Received: September 21, 2022
Peer-review started: September 21, 2022
First decision: January 3, 2023
Revised: January 6, 2023
Accepted: January 30, 2023
Article in press: January 30, 2023
Published online: February 28, 2023
Processing time: 160 Days and 5.1 Hours
Abstract

Hepatocellular carcinoma (HCC) is the most frequent liver neoplasm, and its incidence rates are constantly increasing. Despite the availability of potentially curative treatments (liver transplantation, surgical resection, thermal ablation), long-term outcomes are affected by a high recurrence rate (up to 70% of cases 5 years after treatment). HCC recurrence within 2 years of treatment is defined as “early” and is generally caused by the occult intrahepatic spread of the primary neoplasm and related to the tumor burden. A recurrence that occurs after 2 years of treatment is defined as “late” and is related to de novo HCC, independent of the primary neoplasm. Early HCC recurrence has a significantly poorer prognosis and outcome than late recurrence. Different pathogenesis corresponds to different predictors of the risk of early or late recurrence. An adequate knowledge of predictive factors and recurrence risk stratification guides the therapeutic strategy and post-treatment surveillance. Patients at high risk of HCC recurrence should be referred to treatments with the lowest recurrence rate and when standardized to combined or adjuvant therapy regimens. This review aimed to expose the recurrence predictors and examine the differences between predictors of early and late recurrence.

Keywords: Hepatocellular carcinoma; Early recurrence; Late recurrence; Predictors; Liver transplant; Liver resection; Thermal ablation

Core Tip: Hepatocellular carcinoma is burdened by a high rate of both early and late recurrence. The knowledge of the predictive factors of recurrence and its risk stratification should allow optimization of the management of the patient with hepatocellular carcinoma.