What question did this study set out to answer?

To explore how spatiotemporal recurrence patterns influence survival outcomes in hepatocellular carcinoma patients post-surgery.

April 11, 2026Open Access

The Impact of Spatiotemporal Patterns of Tumor Recurrence on Prognosis in Hepatocellular Carcinoma Patients Undergoing Surgery After Conversion Therapy

Key Points

To explore how spatiotemporal recurrence patterns influence survival outcomes in hepatocellular carcinoma patients post-surgery.
Retrospective analysis of 80 hepatocellular carcinoma patients after conversion therapy and resection
Classification of recurrence based on timing and location
Evaluation of survival using Kaplan-Meier and Cox regression analyses
Exploratory analyses with a 12-month recurrence cutoff for clinical relevance
Recurrence occurred in 52.5% of patients
Early recurrence linked to significantly worse post-recurrence survival (P = 0.04)
Extrahepatic recurrence associated with poorer survival outcomes (P < 0.0001)
Analysis indicates early extrahepatic recurrence has the worst prognosis
Later recurrence timing independently correlates with better post-recurrence survival

Abstract

Purpose: To characterize the spatiotemporal patterns of recurrence and assess their impact on survival in hepatocellular carcinoma (HCC) patients undergoing curative resection after conversion therapy. Methods: We retrospectively analyzed 80 HCC patients who achieved successful conversion and underwent resection between January 2019 and February 2025. Recurrence was classified by timing (early ≤ 10.5 months vs. late > 10.5 months, determined by maximally selected log-rank statistics) and location (intrahepatic vs. extrahepatic) of the first recurrence. Exploratory analyses were also conducted using a 12-month cutoff to align with clinical practice. Post-recurrence survival (PRS), overall survival, and recurrence-free survival were evaluated using Kaplan-Meier analysis. The multivariable Cox models were used to calculate the adjusted hazard ratio and 95% confidence interval for PRS. Results: Recurrence occurred in 52.5% of patients. Early recurrence was associated with significantly worse PRS than late recurrence ( P = 0.04). Although no significant difference in PRS was observed between subgroups when using a 12-month cutoff ( P = 0.1) for the small sample size, this factor still showed a trend toward significance. Extrahepatic recurrence conferred poorer survival than intrahepatic recurrence ( P < 0.0001). Combined spatiotemporal analysis revealed that early extrahepatic recurrence had the worst prognosis, while all late recurrences showed favorable outcomes. Multivariable Cox regression analysis confirmed that the later time recurrence was independently associated with better PRS. Conclusion: In this cohort, time to recurrence is the dominant prognostic factor, with recurrence site providing additional stratification. These findings support the use of spatiotemporal recurrence patterns for risk-adapted surveillance and adjuvant strategies. Keywords: hepatocellular carcinoma, conversion therapy, surgical resection, patterns of recurrence, survival prognosis

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Cite This Study

Chen et al. (Wed,) studied this question.

synapsesocial.com/papers/69d9e64e78050d08c1b76aeb https://doi.org/https://doi.org/10.2147/jhc.s599046

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