Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Gastroenterol. Jun 21, 2026; 32(23): 118308
Published online Jun 21, 2026. doi: 10.3748/wjg.v32.i23.118308
Published online Jun 21, 2026. doi: 10.3748/wjg.v32.i23.118308
Early recurrence risk stratification of hepatocellular carcinoma receiving preoperative radiotherapy: Incorporating clinical and imaging features across treatment phases
Rong Cong, Sai-Nan Cheng, Bing Feng, Le-Yao Wang, Zhao-Wei Chen, Yong-Jian Zhu, Xiao-Hong Ma, Xin-Ming Zhao, Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Bo Chen, Yi-Rui Zhai, Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Fan Wu, Department of Hepatobiliary Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Zhao-Wei Chen, Department of Radiology, Chengdu First People’s Hospital, Chengdu 610000, Sichuan Province, China
Co-first authors: Rong Cong and Bo Chen.
Co-corresponding authors: Xiao-Hong Ma and Xin-Ming Zhao.
Author contributions: Cong R, Chen B, Ma XH, and Zhao XM contributed to the study conception and design; Cong R, Chen B, Cheng SN, Wu F, and Zhai YR were responsible for patient enrollment and data collection; Cong R, Cheng SN, Feng B, Wang LY, Chen ZW, Zhu YJ, Ma XH, and Zhao XM involved in imaging review, data analysis, and interpretation of data; Cong R and Ma XH involved in manuscript preparation; Chen B, and Zhao XM involved in critical revision of the manuscript; Cong R and Chen B contributed equally to this manuscript as co-first authors; Ma XH and Zhao XM contributed equally to this manuscript as co-corresponding authors. All authors reviewed and approved the final manuscript.
Supported by Beijing Hope Run Special Fund of Cancer Foundation of China, No. LC2022A14; and National High Level Hospital Clinical Research Funding, No. 80102022505.
Institutional review board statement: This study was approved by the Ethics Committee of the National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. NCC2023C-936.
Informed consent statement: The need for patient consent was waived due to the retrospective nature of the study.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: If reasonably necessary, the datasets used and analyzed in this study can be obtained from the corresponding author.
Corresponding author: Xin-Ming Zhao, Professor, Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17 Panjiayuan Nanli, Chaoyang District, Beijing 100021, China. zhaoxinming@cicams.ac.cn
Received: December 30, 2025
Revised: January 28, 2026
Accepted: March 9, 2026
Published online: June 21, 2026
Processing time: 161 Days and 1.2 Hours
Revised: January 28, 2026
Accepted: March 9, 2026
Published online: June 21, 2026
Processing time: 161 Days and 1.2 Hours
Core Tip
Core Tip: This study developed two models (baseline-preoperative and postoperative combined models) that integrated multimodal factors across multiple treatment stages in patients with hepatocellular carcinoma who received radiotherapy-based therapy combined with subsequent surgery. These models exhibited comparable and satisfactory performance in predicting early recurrence and allowed risk stratification of early recurrence-free survival, overall recurrence-free survival, and overall survival. Including readily accessible variables, the findings have potential clinical relevance, particularly for preoperative decision-making regarding the timing and personalized planning of surgery after radiotherapy, as well as postoperative management involving adjuvant therapy and close surveillance for high-risk patients.