Preoperative Non-invasive Risk Stratification of Hepatocellular Carcinoma Based on CT
Manman Li, Feng Feng
Acad Radiol . 2023 Nov;30(11):2707-2709. doi: 10.1016/j.acra.2023.06.022. Epub 2023 Aug 14.
Hepatocellular carcinoma (HCC) is the fourth most common cause of cancer-related death worldwide ( 1 ). Surgical resection is one of the most effective treatment options for HCC, but recurrence after surgery remains a major clinical challenge that affects approximately 50–70% of patients within five years of surgery ( 2 , 3 ). There may be significant differences in recurrence and survival after hepatectomy in patients with HCC of the same stage. If patients with poor and good prognosis can be identified before surgery, then for those patients with poor prognosis, the follow-up interval can be shortened appropriately, and appropriate preventive measures can be taken, such as postoperative transarterial chemoembolization or sorafinib adjuvant therapy. On the other hand, patients with relatively good prognosis can avoid excessive treatment, reduce adjuvant therapy, and even carry out long-term follow-up without adjuvant therapy. The Korean model, Singapore Liver Cancer Recurrence score (SLICER) model, and Surgery-Specific Cancer of the Liver Italian Program (SSCLIP) model have been specifically developed to the prognosis of LR ( 4 , 5 , 6 ). However, due to pathological factors, such as microvascular invasion or histological grading, which can only be comprehensively evaluated on postoperative pathological sections, they are not sufficient for preoperative recurrence risk assessment. To enhance the development of clinical management strategies, including treatment plans, perioperative management, and postoperative follow-up, it is essential to establish a preoperative prognostic model. Such a model would provide valuable insights into patient prognosis prior to surgery, enabling more informed decision-making and personalized care.