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Marasco et al. Hepatoma Res 2020;6:33 Hepatoma Research
DOI: 10.20517/2394-5079.2020.01

Review Open Access

Predictive factors for hepatocellular carcinoma
recurrence after curative treatments

Giovanni Marasco , Federico Ravaioli , Amanda Vestito , Benedetta Rossini , Elton Dajti , Luigi
1
1
1
1
1
Colecchia , Kamela Gjini , Matteo Renzulli , Rita Golfieri , Davide Festi , Antonio Colecchia 3
1
2
1
3
2
1 Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna 40138, Italy.
2 Radiology Unit, Sant’Orsola Malpighi Hospital, Bologna 40138, Italy.
3 Unit of Gastroenterology, Borgo Trento University Hospital of Verona, Verona 37126, Italy.
Correspondence to: Dr. Antonio Colecchia, Unit of Gastroenterology, Borgo Trento University Hospital, Verona 37126, Italy.
E-mail: antonio.colecchia@aovr.veneto.it
How to cite this article: Marasco G, Ravaioli F, Vestito A, Rossini B, Dajti E, Colecchia L, Gjini K, Renzulli M, Golfieri R, Festi D,
Colecchia A. Predictive factors for hepatocellular carcinoma recurrence after curative treatments. Hepatoma Res 2020;6:33.
http://dx.doi.org/10.20517/2394-5079.2020.01
Received: 14 Jan 2020 First Decision: 16 Mar 2020 Revised: 13 May 2020 Accepted: 15 May 2020 Published: 18 Jun 2020
Science Editor: Stefano Brillanti Copy Editor: Jing-Wen Zhang Production Editor: Tian Zhang

Abstract
Hepatocellular carcinoma (HCC) is the fifth most common neoplasm worldwide. Recurrence of HCC after
resection or loco-regional therapies represents an important clinical issue as it affects up to 70% of patients.
This can be divided into early or late, if it occurs within or after 24 months after treatment, respectively. While
the predictive factors for early recurrence are mainly related to tumour biology (local invasion and intrahepatic
metastases), late recurrences are mainly related to de novo tumour formation. Thus, it is important to recognize
these factors prior to any treatment in each patient, in order to optimize the treatment strategy and follow-up after
treatment. The aim of this review is to summarize the current evidence available regarding predictive factors for
the recurrence of HCC, according to the different therapeutic strategies available. In particular, we will discuss the
role of new ultrasound-based techniques and biological features, such as tumor-related and circulating biomarkers,
in predicting HCC recurrence. Recent advances in imaging-related parameters in computed-tomography scans
and magnetic resonance imaging will also be discussed.

Keywords: Liver resection, trans-arterial chemoembolization, radiofrequency ablation, liver stiffness measurement,
indocyanine green retention test

INTRODUCTION
Hepatocellular carcinoma (HCC) is the fifth most common tumor and one of the leading causes of cancer
[1,2]
mortality worldwide . To date, the numbers of HCC has not dropped, despite the introduction of new
[3]
direct antiviral agents for hepatitis virus C (HCV) eradication to lower the risk of developing HCC in these
© The Author(s) 2020. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
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