Research progress of risk factors related to recurrence after radical resection of hepatocellular carcinoma_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

LI Jiangpeng , XU Ting ,  LI Jingdong

Department of Hepatobiliary Surgery, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000, P. R. China;

Corresponding author：

LI Jingdong, Email: lijingdong358@126.com

Keywords：

hepatocellular carcinoma; radical resection; tumor recurrence; related factor; research progress; review

DOI：

10.7507/1007-9424.202003140

Video：

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Objective To summarize the research progress of risk factors related to early recurrence and late recurrence of hepatocellular carcinoma (HCC) after radical resection.Methods Reviewed and summarized recent literatures on factors related to early and late recurrence of HCC after radical resection.Results Radical resection was the most effective treatment for HCC, but the postoperative recurrence rate was high, which seriously affected the treatment effect. Current research divided the recurrence after radical resection of HCC into early recurrence (≤2 years) and late recurrence (>2 years). Early recurrence was considered to be mainly caused by intrahepatic metastasis (IM), which was related to the tumor itself, while late recurrence was mainly caused by multicentric occurrence (MO) and was related to background liver factors. Factors of the tumor itself, including tumor diameter and number, invasion of tumor large vessels and microvessels, anatomical and non-anatomical resection, tumor margin, residual liver ischemia (RLI), intermittent total entry hepatic blood flow interruption method (IPM), the expression level of circulating microRNA in serum and long-chain non-coding RNA, circulating tumor cells, and circulating tumor DNA were related to early recurrence; background liver factors, including liver cirrhosis, high viral load, and liver inflammatory activity, were associated with late recurrence.Conclusions Both the tumor factors associated with early recurrence and the background liver factors associated with late recurrence can affect the recurrence after radical resection of HCC.

Citation： LI Jiangpeng, XU Ting, LI Jingdong. Research progress of risk factors related to recurrence after radical resection of hepatocellular carcinoma. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2020, 27(12): 1587-1592. doi: 10.7507/1007-9424.202003140 Copy

1.	Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2018, 68(6): 394-424.
2.	Forner A, Llovet JM, Bruix J. Hepatocellular carcinoma. Lancet, 2012, 379(9822): 1245-1255.
3.	Imamura H, Matsuyama Y, Tanaka E, et al. Risk factors contributing to early and late phase intrahepatic recurrence of hepatocellular carcinoma after hepatectomy. J Hepatol, 2003, 38(2): 200-207.
4.	Shimada M, Hamatsu T, Yamashita Y, et al. Characteristics of multicentric hepatocellular carcinomas: comparison with intrahepatic metastasis. World J Surg, 2001, 25(8): 991-995.
5.	Morimoto O, Nagano H, Sakon M, et al. Diagnosis of intrahepatic metastasis and multicentric carcinogenesis by microsatellite loss of heterozygosity in patients with multiple and recurrent hepatocellular carcinomas. J Hepatol, 2003, 39(2): 215-221.
6.	Xie DY, Fan HK, Ren ZG, et al. Identifying clonal origin of multifocal hepatocellular carcinoma and its clinical implications. Clin Transl Gastroenterol, 2019, 10(2): e00006.
7.	Yang SL, Luo YY, Chen M, et al. A systematic review and meta-analysis comparing the prognosis of multicentric occurrence and vs. intrahepatic metastasis in patients with recurrent hepatocellular carcinoma after hepatectomy. HPB (Oxford), 2017, 19(10): 835-842.
8.	Kim JM, Kwon CH, Joh JW, et al. Intrahepatic metastasis is more risky than multiple occurrence in hepatocellular carcinoma patients after curative liver resection. Hepatogastroenterology, 2015, 62(138): 399-404.
9.	Kobayashi A, Miyagawa S, Miwa S, et al. Prognostic impact of anatomical resection on early and late intrahepatic recurrence in patients with hepatocellular carcinoma. J Hepatobiliary Pancreat Surg, 2008, 15(5): 515-521.
10.	Shah SA, Greig PD, Gallinger S, et al. Factors associated with early recurrence after resection for hepatocellular carcinoma and outcomes. J Am Coll Surg, 2006, 202(2): 275-283.
11.	Colecchia A, Schiumerini R, Cucchetti A, et al. Prognostic factors for hepatocellular carcinoma recurrence. World J Gastroenterol, 2014, 20(20): 5935-5950.
12.	Cucchetti A, Piscaglia F, Caturelli E, et al. Comparison of recurrence of hepatocellular carcinoma after resection in patients with cirrhosis to its occurrence in a surveilled cirrhotic population. Ann Surg Oncol, 2009, 16(2): 413-422.
13.	Zhao J, Li W, Mao J. Early versus late recurrence of centrally located hepatocellular carcinoma after mesohepatectomy: a cohort study based on the STROBE guidelines. Medicine (Baltimore), 2019, 98(23): e15540.
14.	Poon RT, Fan ST, Ng IO, et al. Different risk factors and prognosis for early and late intrahepatic recurrence after resection of hepatocellular carcinoma. Cancer, 2000, 89(3): 500-507.
15.	Portolani N, Coniglio A, Ghidoni S, et al. Early and late recurrence after liver resection for hepatocellular carcinoma: prognostic and therapeutic implications. Ann Surg, 2006, 243(2): 229-235.
16.	Poon RT, Fan ST, Lo CM, et al. Intrahepatic recurrence after curative resection of hepatocellular carcinoma: long-term results of treatment and prognostic factors. Ann Surg, 1999, 229(2): 216-222.
17.	Huang ZY, Liang BY, Xiong M, et al. Long-term outcomes of repeat hepatic resection in patients with recurrent hepatocellular carcinoma and analysis of recurrent types and their prognosis: a single-center experience in China. Ann Surg Oncol, 2012, 19(8): 2515-2525.
18.	Nomoto S, Hishida M, Inokawa Y, et al. Management of hepatocellular carcinoma should consider both tumor factors and background liver factors. Hepatobiliary Surg Nutr, 2014, 3(2): 82-85.
19.	Kaibori M, Ishizaki M, Matsui K, et al. Predictors of microvascular invasion before hepatectomy for hepatocellular carcinoma. J Surg Oncol, 2010, 102(5): 462-468.
20.	Wu TH, Yu MC, Chen TC, et al. Encapsulation is a significant prognostic factor for better outcome in large hepatocellular carcinoma. J Surg Oncol, 2012, 105(1): 85-90.
21.	Regimbeau JM, Abdalla EK, Vauthey JN, et al. Risk factors for early death due to recurrence after liver resection for hepatocellular carcinoma: results of a multicenter study. J Surg Oncol, 2004, 85(1): 36-41.
22.	Kamiyama T, Nakanishi K, Yokoo H, et al. Analysis of the risk factors for early death due to disease recurrence or progression within 1 year after hepatectomy in patients with hepatocellular carcinoma. World J Surg Oncol, 2012, 10: 107.
23.	Tokumitsu Y, Shindo Y, Matsui H, et al. Utility of scoring systems combining the product of tumor number and size with liver function for predicting the prognosis of patients with hepatocellular carcinoma after hepatectomy. Oncol Lett, 2019, 18(4): 3903-3913.
24.	Tokumitsu Y, Sakamoto K, Tokuhisa Y, et al. A new prognostic model for hepatocellular carcinoma recurrence after curative hepatectomy. Oncol Lett, 2018, 15(4): 4411-4422.
25.	Tokumitsu Y, Tamesa T, Matsukuma S, et al. An accurate prognostic staging system for hepatocellular carcinoma patients after curative hepatectomy. Int J Oncol, 2015, 46(3): 944-952.
26.	Roayaie S, Blume IN, Thung SN, et al. A system of classifying microvascular invasion to predict outcome after resection in patients with hepatocellular carcinoma. Gastroenterology, 2009, 137(3): 850-855.
27.	Torzilli G, Belghiti J, Kokudo N, et al. A snapshot of the effective indications and results of surgery for hepatocellular carcinoma in tertiary referral centers: is it adherent to the EASL/AASLD recommendations?: an observational study of the HCC east-west study group. Ann Surg, 2013, 257(5): 929-937.
28.	Xu L, Li L, Wang P, et al. Novel prognostic nomograms for hepatocellular carcinoma patients with microvascular invasion: experience from a single center. Gut Liver, 2019, 13(6): 669-682.
29.	Chen ZH, Zhang XP, Wang H, et al. Effect of microvascular invasion on the postoperative long-term prognosis of solitary small hcc: a systematic review and meta-analysis. HPB (Oxford), 2019, 21(8): 935-944.
30.	Rodríguez-Perálvarez M, Luong TV, Andreana L, et al. A systematic review of microvascular invasion in hepatocellular carcinoma: diagnostic and prognostic variability. Ann Surg Oncol, 2013, 20(1): 325-339.
31.	Cucchetti A, Cescon M, Ercolani G, et al. A comprehensive meta-regression analysis on outcome of anatomic resection versus nonanatomic resection for hepatocellular carcinoma. Ann Surg Oncol, 2012, 19(12): 3697-3705.
32.	Eguchi S, Kanematsu T, Arii S, et al. Comparison of the outcomes between an anatomical subsegmentectomy and a non-anatomical minor hepatectomy for single hepatocellular carcinomas based on a Japanese nationwide survey. Surgery, 2008, 143(4): 469-475.
33.	Shindoh J, Hasegawa K, Inoue Y, et al. Risk factors of post-operative recurrence and adequate surgical approach to improve long-term outcomes of hepatocellular carcinoma. HPB (Oxford), 2013, 15(1): 31-39.
34.	Moris D, Tsilimigras DI, Kostakis ID, et al. Anatomic versus non-anatomic resection for hepatocellular carcinoma: a systematic review and meta-analysis. Eur J Surg Oncol, 2018, 44(7): 927-938.
35.	Lai EC, You KT, Ng IO, et al. The pathological basis of resection margin for hepatocellular carcinoma. World J Surg, 1993, 17(6): 786-790, 791.
36.	Hu LS, Zhang XF, Weiss M, et al. Recurrence patterns and timing courses following curative-intent resection for intrahepatic cholangiocarcinoma. Ann Surg Oncol, 2019, 26(8): 2549-2557.
37.	Shi M, Guo RP, Lin XJ, et al. Partial hepatectomy with wide versus narrow resection margin for solitary hepatocellular carcinoma: a prospective randomized trial. Ann Surg, 2007, 245(1): 36-43.
38.	Tsilimigras DI, Sahara K, Moris D, et al. Effect of surgical margin width on patterns of recurrence among patients undergoing R0 hepatectomy for T1 hepatocellular carcinoma: an international multi-institutional analysis. J Gastrointest Surg, 2019, [Online ahead of print].
39.	Cho JY, Han HS, Choi Y, et al. Association of remnant liver ischemia with early recurrence and poor survival after liver resection in patients with hepatocellular carcinoma. JAMA Surg, 2017, 152(4): 386-392.
40.	Famularo S, Giani A, Di Sandro S, et al. Does the pringle maneuver affect survival and recurrence following surgical resection for hepatocellular carcinoma? A western series of 441 patients. J Surg Oncol, 2018, 117(2): 198-206.
41.	Lin N, Li J, Ke Q, et al. Does the intermittent Pringle maneuver affect the recurrence following surgical resection for hepatocellular carcinoma? A systematic review. PloS one, 2020, 15(3): e229870.
42.	Chuma M, Toyoda H, Matsuzaki J, et al. Circulating microRNA-1246 as a possible biomarker for early tumor recurrence of hepatocellular carcinoma. Hepatol Res, 2019, 49(7): 810-822.
43.	Han B, Huang J, Yang Z, et al. miR-449a is related to short-term recurrence of hepatocellular carcinoma and inhibits migration and invasion by targeting Notch1. Onco Targets Ther, 2019, 12: 10975-10987.
44.	Liu Y, Zhang Y, Zhang T. Long non-coding RNA MACC1-AS1 is involved in distant recurrence of hepatocellular carcinoma after surgical resection. Med Sci Monit, 2020, 26: e921175.
45.	李蒋鹏, 李敬东. 长链非编码 RNA 对肝细胞肝癌的诊断价值. 中国普外基础与临床杂志, 2019, 26(10): 1243-1247.
46.	Ye Q, Ling S, Zheng S, et al. Liquid biopsy in hepatocellular carcinoma: circulating tumor cells and circulating tumor DNA. Mol Cancer, 2019, 18(1): 114.
47.	von Felden J, Schulze K, Krech T, et al. Circulating tumor cells as liquid biomarker for high HCC recurrence risk after curative liver resection. Oncotarget, 2017, 8(52): 89978-89987.
48.	Reinert T, Schøler LV, Thomsen R, et al. Analysis of circulating tumour DNA to monitor disease burden following colorectal cancer surgery. Gut, 2016, 65(4): 625-634.
49.	Wang J, Huang A, Wang YP, et al. Circulating tumor DNA correlates with microvascular invasion and predicts tumor recurrence of hepatocellular carcinoma. Ann Transl Med, 2020, 8(5): 237.
50.	Jung KS, Kim SU, Choi GH, et al. Prediction of recurrence after curative resection of hepatocellular carcinoma using liver stiffness measurement (FibroScan®). Ann Surg Oncol, 2012, 19(13): 4278-4286.
51.	Wu JC, Huang YH, Chau GY, et al. Risk factors for early and late recurrence in hepatitis B-related hepatocellular carcinoma. J Hepatol, 2009, 51(5): 890-897.
52.	Kim H, Lee SJ, Yoon M. Alpha-fetoprotein is correlated with intrahepatic recurrence of hepatocellular carcinoma after a hepatectomy. Ann Surg Treat Res, 2020, 98(4): 168-176.
53.	Cheng Z, Yang P, Qu S, et al. Risk factors and management for early and late intrahepatic recurrence of solitary hepatocellular carcinoma after curative resection. HPB (Oxford), 2015, 17(5): 422-427.
54.	Yamamoto Y, Ikoma H, Morimura R, et al. Optimal duration of the early and late recurrence of hepatocellular carcinoma after hepatectomy. World J Gastroenterol, 2015, 21(4): 1207-1215.

1. Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2018, 68(6): 394-424.
2. Forner A, Llovet JM, Bruix J. Hepatocellular carcinoma. Lancet, 2012, 379(9822): 1245-1255.
3. Imamura H, Matsuyama Y, Tanaka E, et al. Risk factors contributing to early and late phase intrahepatic recurrence of hepatocellular carcinoma after hepatectomy. J Hepatol, 2003, 38(2): 200-207.
4. Shimada M, Hamatsu T, Yamashita Y, et al. Characteristics of multicentric hepatocellular carcinomas: comparison with intrahepatic metastasis. World J Surg, 2001, 25(8): 991-995.
5. Morimoto O, Nagano H, Sakon M, et al. Diagnosis of intrahepatic metastasis and multicentric carcinogenesis by microsatellite loss of heterozygosity in patients with multiple and recurrent hepatocellular carcinomas. J Hepatol, 2003, 39(2): 215-221.
6. Xie DY, Fan HK, Ren ZG, et al. Identifying clonal origin of multifocal hepatocellular carcinoma and its clinical implications. Clin Transl Gastroenterol, 2019, 10(2): e00006.
7. Yang SL, Luo YY, Chen M, et al. A systematic review and meta-analysis comparing the prognosis of multicentric occurrence and vs. intrahepatic metastasis in patients with recurrent hepatocellular carcinoma after hepatectomy. HPB (Oxford), 2017, 19(10): 835-842.
8. Kim JM, Kwon CH, Joh JW, et al. Intrahepatic metastasis is more risky than multiple occurrence in hepatocellular carcinoma patients after curative liver resection. Hepatogastroenterology, 2015, 62(138): 399-404.
9. Kobayashi A, Miyagawa S, Miwa S, et al. Prognostic impact of anatomical resection on early and late intrahepatic recurrence in patients with hepatocellular carcinoma. J Hepatobiliary Pancreat Surg, 2008, 15(5): 515-521.
10. Shah SA, Greig PD, Gallinger S, et al. Factors associated with early recurrence after resection for hepatocellular carcinoma and outcomes. J Am Coll Surg, 2006, 202(2): 275-283.
11. Colecchia A, Schiumerini R, Cucchetti A, et al. Prognostic factors for hepatocellular carcinoma recurrence. World J Gastroenterol, 2014, 20(20): 5935-5950.
12. Cucchetti A, Piscaglia F, Caturelli E, et al. Comparison of recurrence of hepatocellular carcinoma after resection in patients with cirrhosis to its occurrence in a surveilled cirrhotic population. Ann Surg Oncol, 2009, 16(2): 413-422.
13. Zhao J, Li W, Mao J. Early versus late recurrence of centrally located hepatocellular carcinoma after mesohepatectomy: a cohort study based on the STROBE guidelines. Medicine (Baltimore), 2019, 98(23): e15540.
14. Poon RT, Fan ST, Ng IO, et al. Different risk factors and prognosis for early and late intrahepatic recurrence after resection of hepatocellular carcinoma. Cancer, 2000, 89(3): 500-507.
15. Portolani N, Coniglio A, Ghidoni S, et al. Early and late recurrence after liver resection for hepatocellular carcinoma: prognostic and therapeutic implications. Ann Surg, 2006, 243(2): 229-235.
16. Poon RT, Fan ST, Lo CM, et al. Intrahepatic recurrence after curative resection of hepatocellular carcinoma: long-term results of treatment and prognostic factors. Ann Surg, 1999, 229(2): 216-222.
17. Huang ZY, Liang BY, Xiong M, et al. Long-term outcomes of repeat hepatic resection in patients with recurrent hepatocellular carcinoma and analysis of recurrent types and their prognosis: a single-center experience in China. Ann Surg Oncol, 2012, 19(8): 2515-2525.
18. Nomoto S, Hishida M, Inokawa Y, et al. Management of hepatocellular carcinoma should consider both tumor factors and background liver factors. Hepatobiliary Surg Nutr, 2014, 3(2): 82-85.
19. Kaibori M, Ishizaki M, Matsui K, et al. Predictors of microvascular invasion before hepatectomy for hepatocellular carcinoma. J Surg Oncol, 2010, 102(5): 462-468.
20. Wu TH, Yu MC, Chen TC, et al. Encapsulation is a significant prognostic factor for better outcome in large hepatocellular carcinoma. J Surg Oncol, 2012, 105(1): 85-90.
21. Regimbeau JM, Abdalla EK, Vauthey JN, et al. Risk factors for early death due to recurrence after liver resection for hepatocellular carcinoma: results of a multicenter study. J Surg Oncol, 2004, 85(1): 36-41.
22. Kamiyama T, Nakanishi K, Yokoo H, et al. Analysis of the risk factors for early death due to disease recurrence or progression within 1 year after hepatectomy in patients with hepatocellular carcinoma. World J Surg Oncol, 2012, 10: 107.
23. Tokumitsu Y, Shindo Y, Matsui H, et al. Utility of scoring systems combining the product of tumor number and size with liver function for predicting the prognosis of patients with hepatocellular carcinoma after hepatectomy. Oncol Lett, 2019, 18(4): 3903-3913.
24. Tokumitsu Y, Sakamoto K, Tokuhisa Y, et al. A new prognostic model for hepatocellular carcinoma recurrence after curative hepatectomy. Oncol Lett, 2018, 15(4): 4411-4422.
25. Tokumitsu Y, Tamesa T, Matsukuma S, et al. An accurate prognostic staging system for hepatocellular carcinoma patients after curative hepatectomy. Int J Oncol, 2015, 46(3): 944-952.
26. Roayaie S, Blume IN, Thung SN, et al. A system of classifying microvascular invasion to predict outcome after resection in patients with hepatocellular carcinoma. Gastroenterology, 2009, 137(3): 850-855.
27. Torzilli G, Belghiti J, Kokudo N, et al. A snapshot of the effective indications and results of surgery for hepatocellular carcinoma in tertiary referral centers: is it adherent to the EASL/AASLD recommendations?: an observational study of the HCC east-west study group. Ann Surg, 2013, 257(5): 929-937.
28. Xu L, Li L, Wang P, et al. Novel prognostic nomograms for hepatocellular carcinoma patients with microvascular invasion: experience from a single center. Gut Liver, 2019, 13(6): 669-682.
29. Chen ZH, Zhang XP, Wang H, et al. Effect of microvascular invasion on the postoperative long-term prognosis of solitary small hcc: a systematic review and meta-analysis. HPB (Oxford), 2019, 21(8): 935-944.
30. Rodríguez-Perálvarez M, Luong TV, Andreana L, et al. A systematic review of microvascular invasion in hepatocellular carcinoma: diagnostic and prognostic variability. Ann Surg Oncol, 2013, 20(1): 325-339.
31. Cucchetti A, Cescon M, Ercolani G, et al. A comprehensive meta-regression analysis on outcome of anatomic resection versus nonanatomic resection for hepatocellular carcinoma. Ann Surg Oncol, 2012, 19(12): 3697-3705.
32. Eguchi S, Kanematsu T, Arii S, et al. Comparison of the outcomes between an anatomical subsegmentectomy and a non-anatomical minor hepatectomy for single hepatocellular carcinomas based on a Japanese nationwide survey. Surgery, 2008, 143(4): 469-475.
33. Shindoh J, Hasegawa K, Inoue Y, et al. Risk factors of post-operative recurrence and adequate surgical approach to improve long-term outcomes of hepatocellular carcinoma. HPB (Oxford), 2013, 15(1): 31-39.
34. Moris D, Tsilimigras DI, Kostakis ID, et al. Anatomic versus non-anatomic resection for hepatocellular carcinoma: a systematic review and meta-analysis. Eur J Surg Oncol, 2018, 44(7): 927-938.
35. Lai EC, You KT, Ng IO, et al. The pathological basis of resection margin for hepatocellular carcinoma. World J Surg, 1993, 17(6): 786-790, 791.
36. Hu LS, Zhang XF, Weiss M, et al. Recurrence patterns and timing courses following curative-intent resection for intrahepatic cholangiocarcinoma. Ann Surg Oncol, 2019, 26(8): 2549-2557.
37. Shi M, Guo RP, Lin XJ, et al. Partial hepatectomy with wide versus narrow resection margin for solitary hepatocellular carcinoma: a prospective randomized trial. Ann Surg, 2007, 245(1): 36-43.
38. Tsilimigras DI, Sahara K, Moris D, et al. Effect of surgical margin width on patterns of recurrence among patients undergoing R0 hepatectomy for T1 hepatocellular carcinoma: an international multi-institutional analysis. J Gastrointest Surg, 2019, [Online ahead of print].
39. Cho JY, Han HS, Choi Y, et al. Association of remnant liver ischemia with early recurrence and poor survival after liver resection in patients with hepatocellular carcinoma. JAMA Surg, 2017, 152(4): 386-392.
40. Famularo S, Giani A, Di Sandro S, et al. Does the pringle maneuver affect survival and recurrence following surgical resection for hepatocellular carcinoma? A western series of 441 patients. J Surg Oncol, 2018, 117(2): 198-206.
41. Lin N, Li J, Ke Q, et al. Does the intermittent Pringle maneuver affect the recurrence following surgical resection for hepatocellular carcinoma? A systematic review. PloS one, 2020, 15(3): e229870.
42. Chuma M, Toyoda H, Matsuzaki J, et al. Circulating microRNA-1246 as a possible biomarker for early tumor recurrence of hepatocellular carcinoma. Hepatol Res, 2019, 49(7): 810-822.
43. Han B, Huang J, Yang Z, et al. miR-449a is related to short-term recurrence of hepatocellular carcinoma and inhibits migration and invasion by targeting Notch1. Onco Targets Ther, 2019, 12: 10975-10987.
44. Liu Y, Zhang Y, Zhang T. Long non-coding RNA MACC1-AS1 is involved in distant recurrence of hepatocellular carcinoma after surgical resection. Med Sci Monit, 2020, 26: e921175.
45. 李蒋鹏, 李敬东. 长链非编码 RNA 对肝细胞肝癌的诊断价值. 中国普外基础与临床杂志, 2019, 26(10): 1243-1247.
46. Ye Q, Ling S, Zheng S, et al. Liquid biopsy in hepatocellular carcinoma: circulating tumor cells and circulating tumor DNA. Mol Cancer, 2019, 18(1): 114.
47. von Felden J, Schulze K, Krech T, et al. Circulating tumor cells as liquid biomarker for high HCC recurrence risk after curative liver resection. Oncotarget, 2017, 8(52): 89978-89987.
48. Reinert T, Schøler LV, Thomsen R, et al. Analysis of circulating tumour DNA to monitor disease burden following colorectal cancer surgery. Gut, 2016, 65(4): 625-634.
49. Wang J, Huang A, Wang YP, et al. Circulating tumor DNA correlates with microvascular invasion and predicts tumor recurrence of hepatocellular carcinoma. Ann Transl Med, 2020, 8(5): 237.
50. Jung KS, Kim SU, Choi GH, et al. Prediction of recurrence after curative resection of hepatocellular carcinoma using liver stiffness measurement (FibroScan®). Ann Surg Oncol, 2012, 19(13): 4278-4286.
51. Wu JC, Huang YH, Chau GY, et al. Risk factors for early and late recurrence in hepatitis B-related hepatocellular carcinoma. J Hepatol, 2009, 51(5): 890-897.
52. Kim H, Lee SJ, Yoon M. Alpha-fetoprotein is correlated with intrahepatic recurrence of hepatocellular carcinoma after a hepatectomy. Ann Surg Treat Res, 2020, 98(4): 168-176.
53. Cheng Z, Yang P, Qu S, et al. Risk factors and management for early and late intrahepatic recurrence of solitary hepatocellular carcinoma after curative resection. HPB (Oxford), 2015, 17(5): 422-427.
54. Yamamoto Y, Ikoma H, Morimura R, et al. Optimal duration of the early and late recurrence of hepatocellular carcinoma after hepatectomy. World J Gastroenterol, 2015, 21(4): 1207-1215.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Research progress of risk factors related to recurrence after radical resection of hepatocellular carcinoma

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