High fib-4 index and microvascular invasion predict late recurrence.

In a cohort of 769 hepatocellular carcinoma survivors, 21.6% experienced late recurrence post-treatment. Key findings showed that patients with late recurrence exhibited a higher fib-4 index (median 2.31) and a tendency toward microvascular invasion. Both factors were independently associated with worse recurrence-free survival (RFS). Patients identified as high-risk had a two-fold increase in recurrence hazard at five years. These distinct risk patterns suggest a need for personalized postoperative surveillance to enhance early detection of recurrence.