Evidence map›Paper›PMID 42283967›Full record

ArticleHepatology international2026

Identifying a biologically high-risk subgroup of anatomically resectable hepatocellular carcinoma.

Kazunari Tanaka, Kunihiko Tsuji, Atsushi Hiraoka, Toshifumi Tada, Kazuya Kariyama, Ei Itobayashi, Toru Ishikawa, Hidenori Toyoda, Yuichi Koshiyama, Takeshi Hatanaka and 17 more

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Article in Hepatology international, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

27 authors.

Kazunari TanakaCenter for Gastroenterology, Teine Keijinkai Hospital, 1-40-1-12 Maeda, Teine-Ku, Sapporo, 006-8555, Japan. kazunari0511@gmail.com.ORCID http://orcid.org/0000-0001-9811-2665
Kunihiko TsujiCenter for Gastroenterology, Teine Keijinkai Hospital, 1-40-1-12 Maeda, Teine-Ku, Sapporo, 006-8555, Japan.
Atsushi HiraokaGastroenterology Center, Ehime Prefectural Central Hospital, Matsuyama, Japan.
Toshifumi TadaDivision of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.
Kazuya KariyamaDepartment of Gastroenterology, Okayama City Hospital, Okayama, Japan.
Ei ItobayashiDepartment of Gastroenterology, Asahi General Hospital, Asahi, Japan.
Toru IshikawaDepartment of Gastroenterology, Saiseikai Niigata Hospital, Niigata, Japan.
Hidenori ToyodaDepartment of Gastroenterology and Hepatology, Ogaki Municipal Hospital, Ogaki, Japan.
Yuichi KoshiyamaDepartment of Gastroenterology and Hepatology, Ogaki Municipal Hospital, Ogaki, Japan.
Takeshi HatanakaDepartment of Gastroenterology, Gunma Saiseikai Maebashi Hospital, Maebashi, Japan.
Satoru KakizakiDepartment of Clinical Research, NHO Takasaki General Medical Center, Takasaki, Japan.
Atsushi NaganumaDepartment of Gastroenterology, NHO Takasaki General Medical Center, Takasaki, Japan.
Tomomitsu MatonoDepartment of Gastroenterology, Hyogo Prefectural Harima-Himeji General Medical Center, Himeji, Japan.
Yoshihide UedaDepartment of Gastroenterology, Kakogawa Central City Hospital, Kakogawa, Japan.
Hironori TanakaDepartment of Gastroenterology, Takarazuka City Hospital, Hyogo, Japan.
Jumpei OkamuraDepartment of Hepatology, Wakayama Rosai Hospital, Wakayama, Japan.
Hideyuki TamaiDepartment of Hepatology, Wakayama Rosai Hospital, Wakayama, Japan.
Kenji KuwakiDepartment of Hepatology, Okayama Saiseikai General Hospital, Okayama, Japan.
Fujimasa TadaGastroenterology Center, Ehime Prefectural Central Hospital, Matsuyama, Japan.
Hideko OhamaGastroenterology Center, Ehime Prefectural Central Hospital, Matsuyama, Japan.
Yuki KanayamaDepartment of Gastroenterology, Gunma Saiseikai Maebashi Hospital, Maebashi, Japan.
Kazuhiro NousoDepartment of Gastroenterology, Okayama City Hospital, Okayama, Japan.
Michitaka ImaiDepartment of Gastroenterology, Saiseikai Niigata Hospital, Niigata, Japan.
Shinichiro NakamuraDepartment of Internal Medicine, Japanese Red Cross Society Himeji Hospital, Himeji, Japan.
Soo Ki KimDepartment of Gastroenterology, Kobe Asahi Hospital, Kobe, Japan.
Takashi KumadaGifu Kyoritsu University, Ogaki, Japan.
Real life Practice Experts for HCC (RELPEC) Study Group

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND &

aimsAlthough anatomically resectable hepatocellular carcinoma (HCC) is generally treated with surgery alone, a substantial proportion of patients experience early recurrence, suggesting underlying biological aggressiveness. We aimed to identify a biologically high-risk subgroup among anatomically resectable HCCs and to develop a simple preoperative biology-based risk score.

methodsIn this multicenter retrospective cohort study, patients who underwent curative-intent hepatectomy for anatomically resectable HCC were temporally divided into training and validation cohorts. Early recurrence was defined as recurrence within 2 years after surgery. Independent predictors were identified using multivariable logistic regression and incorporated into a risk score. Predictive performance was assessed by recurrence-free survival (RFS), AUC, Akaike information criterion, and calibration analysis.

resultsAlpha-fetoprotein (AFP), des-gamma-carboxy prothrombin (DCP), and the fibrosis-related host factor FIB-3 were independently associated with early recurrence and were integrated into the ADF (AFP, DCP and FIB-3) score (range, 0-3). In the validation cohort, higher ADF scores were associated with progressively worse RFS (p < 0.001). The ADF score outperformed each individual component alone, showed good calibration, and the addition of tumor size improved discrimination.

conclusionsThe ADF score identifies a biologically high-risk subgroup within anatomically resectable HCC that is prone to early postoperative recurrence. This biology-based framework may complement anatomical assessment and help refine preoperative risk stratification.

Indexed as

Alpha-fetoproteinBiologically high-risk subgroupDes-gamma-carboxy prothrombinEarly recurrenceFIB-3 indexHepatectomyHepatocellular carcinomaPreoperative risk stratificationRecurrence-free survivalResectability

Identifiers

PMID42283967

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.