Table 3.

Prognostic Role of Circulating Tumor Cells for Hepatocellular Carcinoma.

Study	Region	Year of Study	Type of Study	HCC Patient Number	Technique of Isolation	Key Findings
Chen et al. [99]	China	2014–2020	Retrospective analysis	136	CanPatrol, filtration and multiple mRNA ISH	CTC-WBC cluster ≥ 1/5 mL was associated with distant metastasis, tumor relapse and a shorter RFS
Kelly et al. [87]	USA	2011–2012	Prospective study	20	CellSearch	CTCs ≥ 1 per 7.5 mL was associated with AFP ≥ 400 ng/mL and vascular invasion
Liu et al. [88]	China	2013	Prospective study	60	CD45-ICAM-1+	High frequency of CD45-ICAM-1+ cells (≥0.157%) was associated with a shorter DFS and OS. It is an independent risk factor for poor outcomes, including portal vein tumor thrombus and the presence of ascites
Sun et al. [90]	China	2010–2011	Prospective study	123	CellSearch	CTCs ≥ 2 per 7.5 mL was found to be significantly associated with aggressive HCC phenotypes
Schulze et al. [89]	Germany	2013	Prospective study	59	CellSearch	The presence of CTCs was associated with shorter OS advanced BCLC stage (stage C), microscopic vascular invasion, and elevated AFP ≥ 400 ng/mL
Vona et al. [60]	France	2004	Prospective study	44	ISET method	The presence of CTCs was associated with diffuse tumors and portal tumor thrombosis.
Yang et al. [101]	China	2014–2017	Prospective study	105	CanPatrol	M-CTC positivity was associated with AFP ≥ 400 ng/mL, tumor size ≥ 5 cm, the presence of multiple tumors, poorly differentiated tumors, incomplete tumor capsule, BCLC stage B or C, microvascular invasion and portal vein tumor thrombosis

ISH: In Situ Hybridization; RFS: Relapse-Free Survival; TNM: Tumor (T), Nodes (N), and Metastases (M); OS: Overall Survival; DFS: Disease-Free Survival; BCLC: Barcelona Clinic Liver Cancer; ISET: Isolation by Size of Tumor cells.