Predictors of early and late hepatocellular carcinoma recurrence

Hepatocellular carcinoma(HCC)is the most frequent liver neoplasm,and its incidence rates are constantly increasing.Despite the availability of potentially curative treatments(liver transplantation,surgical resection,thermal ablation),long-term outcomes are affected by a high recurrence rate(up to 70%of cases 5 years after treatment).HCC recurrence within 2 years of treatment is defined as“early”and is generally caused by the occult intrahepatic spread of the primary neoplasm and related to the tumor burden.A recurrence that occurs after 2 years of treatment is defined as“late”and is related to de novo HCC,independent of the primary neoplasm.Early HCC recurrence has a significantly poorer prognosis and outcome than late recurrence.Different pathogenesis corresponds to different predictors of the risk of early or late recurrence.An adequate knowledge of predictive factors and recurrence risk stratification guides the therapeutic strategy and post-treatment surveillance.Patients at high risk of HCC recurrence should be referred to treatments with the lowest recurrence rate and when standardized to combined or adjuvant therapy regimens.This review aimed to expose the recurrence predictors and examine the differences between predictors of early and late recurrence.

Impact of chronic liver disease on SARS-CoV-2 infection outcomes:Roles of stage,etiology and vaccination

Since the first identification in December of 2019 and the fast spread of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection,it has represented a dramatic global public health concern.Though affecting mainly the respiratory system,SARS-CoV-2 disease,defined as coronavirus disease 2019(COVID-19),may have a systemic involvement leading to multiple organ dysfunction.Experimental evidence about the SARS-CoV-2 tropism for the liver and the increasing of hepatic cytolysis enzymes during infection support the presence of a pathophysiological relationship between liver and SARS-CoV-2.On the other side,patients with chronic liver disease have been demonstrated to have a poor prognosis with COVID-19.In particular,patients with liver cirrhosis appear extremely vulnerable to infection.Moreover,the etiology of liver disease and the vaccination status could affect the COVID-19 outcomes.This review analyzes the impact of the disease stage and the related causes on morbidity and mortality,clinical outcomes during SARS-CoV-2 infection,as well as the efficacy of vaccination in patients with chronic liver disease.