Extrahepatic Recurrence After Surgical Resection of Hepatocellular Carcinoma Without Intrahepatic Recurrence: A Multi-Institutional Observational Study

Hepatocellular carcinoma (HCC) is the most common type of liver cancer, and its recurrence outside the liver, known as extrahepatic recurrence (EHR), is associated with poor prognosis. While EHR typically occurs in patients with high-risk factors, its development without detectable HCC remaining in the liver is not well understood. This study aims to identify the clinical characteristics and risk factors associated with EHR in patients who have undergone curative liver surgery for HCC. By analyzing data from 569 patients, we found that microvascular invasion, tumor necrosis, and advanced tumor stage significantly increased the likelihood of EHR. Furthermore, EHR was linked to shorter survival after surgery. These findings highlight the importance of close monitoring in high-risk patients, as detecting and managing EHR early may improve outcomes.