# Predictive Value of Serum Autotaxin for Hepatocellular Carcinoma Recurrence After Curative Radiofrequency Ablation

## TL;DR

This study shows that high levels of a protein called autotaxin in the blood can predict if liver cancer will return after a specific treatment called radiofrequency ablation.

## Contribution

The study identifies autotaxin as a novel and robust biomarker for predicting hepatocellular carcinoma recurrence after curative radiofrequency ablation.

## Key findings

- Serum autotaxin (ATX) levels were a strong independent predictor of hepatocellular carcinoma recurrence after radiofrequency ablation.
- ATX demonstrated superior predictive performance with an area under the curve of 0.729, sensitivity of 0.857, and specificity of 0.629.
- High ATX levels were associated with significantly higher recurrence rates compared to low ATX levels (p = 0.0006).

## Abstract

Despite recent treatment advancements, the high recurrence rate of hepatocellular carcinoma (HCC) following curative therapy remains a significant challenge. Autotaxin (ATX) is a key biomarker in chronic liver disease that has a yet unclarified role in predicting HCC recurrence. This study examined whether precurative radiofrequency ablation (RFA) serum ATX level could serve as a predictor of HCC recurrence after treatment.

Fifty‐six HCC patients (37 [66%] male; median age: 74 years) treated by curative RFA were retrospectively analyzed.

Twenty‐one patients experienced HCC recurrence during follow‐up. ATX demonstrated superior predictive performance for HCC recurrence after RFA, with an area under the receiver operating characteristic curve of 0.729, sensitivity of 0.857, and specificity of 0.629. Kaplan–Meier analysis revealed that patients with high ATX had a significantly higher incidence of HCC recurrence than those with low ATX (p = 0.0006). In univariate analysis, the significant predictors of HCC recurrence included ATX (≥ 1.323 mg/L; hazard ratio [HR]: 6.49; 95% confidence interval [CI]: 1.90–22.13; p = 0.003), fibrosis‐4 index (≥ 3.524; HR: 2.75; 95% CI: 1.00–7.55; p = 0.050), and mac‐2 binding protein glycosylation isomer (≥ 3.85; HR: 2.12; 95% CI: 1.08–4.19; p = 0.030). According to multivariate Cox proportional hazards analysis with seven different models adjusting for age and various established biomarkers, ATX consistently emerged as the only significant independent predictor of HCC recurrence, with HR values ranging from 6.38 to 10.50 (all p < 0.05).

Serum ATX is a promising biomarker for predicting HCC recurrence post‐RFA treatment that may outperform conventional markers.

Serum autotaxin (ATX) is a novel and robust biomarker for predicting hepatocellular carcinoma (HCC) recurrence after curative radiofrequency ablation (RFA). Elevated ATX levels independently predict recurrence, outperforming traditional markers and highlighting its potential for personalized post‐RFA surveillance strategies.