Risk of tumour recurrence following curative treatment of hepatocellular carcinoma

Tumour recurrence remains a major obstacle to long-term survival following curative treatment for hepatocellular carcinoma (HCC). This cohort study aimed to identify clinical and tumour-related factors associated with HCC recurrence. A total of 346 patients treated with curative intent at Karolinska University Hospital between 2010 and 2017 were analysed. Patients were stratified by treatment modality and recurrence status. Resection (adjusted hazard ratio [aHR] = 6.0, 95%CI = 2.5–14.5) and ablation (aHR = 10.3, 95%CI = 4.5–23.7) were independently associated with higher recurrence compared to liver transplantation. Alpha-fetoprotein (AFP) levels ≥100 µg/L (aHR = 3.1, 95%CI = 2.0–4.7) and active smoking at baseline (aHR = 1.7, 95%CI = 1.1–2.6) were significantly associated with recurrence. These findings highlight the relevance of AFP in recurrence prediction and surveillance planning and points out that smoking history can be of importance although this needs to be further validated.

肝细胞癌（hepatocellular carcinoma, HCC）根治性治疗后，肿瘤复发仍是阻碍患者实现长期生存的主要障碍。本队列研究旨在探寻与HCC复发相关的临床及肿瘤相关危险因素。本研究分析了2010年至2017年间于卡罗林斯卡大学医院接受根治性治疗的346例患者，并根据治疗方式及复发状态对患者进行分层分析。相较于肝移植，肝切除术（校正风险比[adjusted hazard ratio, aHR]=6.0，95%置信区间[95% confidence interval, 95%CI]=2.5~14.5）与消融术（aHR=10.3，95%CI=4.5~23.7）均为复发风险升高的独立相关因素。甲胎蛋白（Alpha-fetoprotein, AFP）水平≥100μg/L（aHR=3.1，95%CI=2.0~4.7）以及基线时存在主动吸烟行为（aHR=1.7，95%CI=1.1~2.6）均与肿瘤复发存在显著相关性。本研究结果凸显了AFP在复发预测与随访监测方案制定中的应用价值，同时指出吸烟史对复发风险的影响具备临床参考意义，但该结论仍需进一步验证。