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.