{
  "abstract": "Background After ablation for hepatocellular carcinoma (HCC), liver function and recurrence can evolve over time. We sought to characterize their time-dependent patterns after ablation and quantify transitions among clinically interpretable joint states.Methods We included 266 treatment-naïve, first-line HCC patients treated with ablation (mean follow-up 14.2 months, range 1–66). Liver function was categorized by ALBI grade (classic cutoffs), and recurrence was recorded as present/absent at each assessment. We defined 7 states: (1) ALBI1/no recurrence, (2) ALBI2/no recurrence, (3) ALBI3/no recurrence, (4) ALBI1/recurrence, (5) ALBI2/recurrence, (6) ALBI3/recurrence, and (7) death. All patients entered the model in states 1–3 at baseline. Follow-up ended at the first occurrence of recurrence or death (states 4–7). We summarized time-binned state distributions and estimated transition probabilities. ( IDDF2026-ABS-0043 Figure 1. Change of post-ablation state)Results Time-binned summaries indicated an overall shift toward better liver function after ablation, with increasing proportions of ALBI grade 1 and more favorable ALBI scores over follow-up. In the observed transition counts (939 inter-visit transitions from baseline non-recurrence states), transitions were dominated by state persistence (689/939, 73.4%) and switching within non-recurrence liver-function states (179/939, 19.1%), while transitions to recurrence states accounted for 67/939 (7.1%) and transitions to death were rare (4/939, 0.4%). Using the 12-month (11–13 months) transition probability matrix from baseline states, the probability of remaining recurrence-free at 12 months was 0.706, 0.678, and 0.626 for baseline ALBI grades 1, 2, and 3, respectively; corresponding probabilities of recurrence were 0.238, 0.254, and 0.284, and of death were 0.056, 0.067, and 0.090. Among 81 patients assessed around 1 year, 72 (88.9%) remained in states 1–2 (ALBI 1–2, no recurrence).Conclusions A seven-state framework integrating ALBI and recurrence provides a clinically intuitive, time-resolved description of the post-ablation course in treatment-naïve HCC, capturing liver function trajectories while jointly tracking progression to recurrence and death.Abstract IDDF2026-ABS-0043 Figure 1",
  "authors": [
    {
      "affiliations": [
        "Sun Yat-sen University First Affiliated Hospital, China"
      ],
      "name": "Jiayao Huang"
    },
    {
      "affiliations": [
        "Sun Yat-sen University First Affiliated Hospital, China"
      ],
      "name": "Manxia Lin"
    },
    {
      "affiliations": [
        "Sun Yat-sen University First Affiliated Hospital, China"
      ],
      "name": "Xiaoyan Xie"
    }
  ],
  "title": "IDDF2026-ABS-0043 Post-ablation evolution of liver function and recurrence in treatment-naïve HCC: a seven-state multi-state model integrating ALBI grade and recurrence",
  "uid": "eb20510d-4f8d-5d74-8d64-a805bc97b11b"
}