Establishment and validation of an intratumoral fibrosis-based nomogram for predicting aggressive recurrence after liver resection in hepatocellular carcinoma

BACKGROUND Aggressive recurrence after liver resection (LRE) in hepatocellular carcinoma (HCC) is associated with unfavorable clinical outcomes. Intratumoral fibrosis (ITF) is mechanistically associated with aggressive recurrence, promoting immunosuppression, angiogenesis, and matrix stiffening, thereby supporting its potential as a predictive biomarker. AIM To develop and validate a competing risk nomogram incorporating ITF to predict aggressive HCC recurrence after LRE. METHODS This study incl