How common is recurrence of hepatocellular carcinoma (HCC)?

Updated: Jan 31, 2021
  • Author: Luca Cicalese, MD, FACS; Chief Editor: John Geibel, MD, MSc, DSc, AGAF  more...
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Despite optimal treatment, HCC continues to have a high recurrence rate. It recurs in 50-80% of patients following resection, with the majority of recurrences developing within 2 years. [100] Careful follow-up in the postoperative period is mandatory. Early recurrence after resection is associated with a dismal prognosis, reducing 5-year survival rates from 70% to 30%. [100] Factors that increase the likelihood of recurrence include the presence of multiple foci of HCC, liver capsule invasion, and tumor size greater than 5 cm. Vascular invasion, both microscopic and macroscopic, also correlates with a higher risk of recurrence.

Among patients undergoing liver transplantation, the rate of recurrence is dependent upon the characteristics of the tumor in the explanted liver. [101] Overall recurrence in patients transplanted within the Milan criteria is 4-10%. [82] The majority of these recurrences occur early (8-14 months); however, as many as 30% of recurrences may occur late. [102] In these patients, 23% develop only intrahepatic recurrence, 39% develop both intrahepatic and extrahepatic recurrence, and 39% develop only extrahepatic recurrence. Common extrahepatic sites of metastatic disease include lung, bone, central nervous system, and adrenal glands.

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