Aggressive Histologic Subtypes Drive Poor Outcomes after Percutaneous Ablation for Early Recurrent Hepatocellular...

Area of Science:

• Hepatobiliary surgery
• Oncology
• Tumor microenvironment

Background:

• Hepatocellular carcinoma (HCC) recurrence after resection is common.
• Early intrahepatic recurrence necessitates timely intervention, often with ablation.
• Predictive factors for outcomes after ablation for recurrent HCC require further elucidation.

Purpose of the Study:

• To assess the influence of primary tumor histology on survival and recurrence patterns in patients with early intrahepatic HCC recurrence treated with ablation.
• To determine if primary tumor characteristics can predict outcomes in the context of recurrent HCC post-ablation.

Main Methods:

• Retrospective analysis of 194 patients undergoing ablation for first intrahepatic HCC recurrence within two years of curative resection.
• Evaluation of primary tumor histology (including aggressive subtypes like macrotrabecular-massive and scirrhous) using multivariable Cox and logistic regression.
• Development of a risk model incorporating histology and clinical factors for survival prediction.

Main Results:

• Aggressive primary tumor histology was observed in 14.9% of patients.
• Aggressive histology independently predicted poorer recurrence-free survival (RFS) and overall survival (OS).
• A combined risk model stratified patients into high- and low-risk groups for RFS and OS, and aggressive histology correlated with aggressive recurrence patterns.

Conclusions:

• Primary tumor histology is an independent predictor of outcomes in patients with early recurrent HCC treated with ablation.
• Incorporating primary tumor histology into risk stratification and treatment planning can optimize management strategies for recurrent HCC.
• Histologic subtype may guide surveillance intensity and post-ablation therapeutic decisions for individual patients.