ASO Author Reflections: Enhancing Recurrence-Free Survival Prediction in Hepatocellular Carcinoma: A Time-Updated Model Incorporating Tumor Burden and AFP Dynamics

Hepatocellular carcinoma (HCC) remains a global health challenge, with postoperative recurrence exceeding 40-50% within 2 years after curative-intent hepatectomy. 1,2istorically, prediction models have largely focused on static preoperative factors-most notably alpha-fetoprotein (AFP) and the tumor burden score (TBS)-to estimate recurrencefree survival (RFS). 3,4While offering valuable baseline insights, these predictors fail to capture changes in tumor biology that occur after resection.Serum AFP has long been monitored as a biomarker for HCC, reflecting active tumor growth or residual tumor cells.Prior models have not fully leveraged longitudinal AFP data, which may help inform evolving risk of recurrence.The current study investigated real-time RFS prediction by integrating time-updated AFP and tumor burden metrics.