title: Influencing elements and treatment strategies associated with the relapse of hepatocellular carcinoma after surgery.
abstract: OBJECTIVE
  Long-term prognosis after surgical resection of Hepatocellular Carcinoma remains unsatisfactory, mainly because of the high postoperative incidence of recurrence and metastasis. An updated knowledge on the influencing factors of recurrence and treatment strategies of postoperative recurrence is important for clinicians in designing a strategy to optimize the chance of long-term survival in patients undergoing hepatic resection for HCC.
  
  
  METHODS
  Using key words “Hepatocellular Carcinoma”, “liver cancer”, “resection”, “postoperative recurrence”, “treatment strategy”, “therapy”, “influencing factors”, “risk factors”, we performed a review of relevant English articles based on based on a Medline search before May 2012.
  
  
  RESULTS
  Influencing factors include tumor size, venous invasion, satellite nodules, cirrhosis, alpha-foetoprotein, aspartate aminotransferase, alkaline phosphatase levels, hepatitis B virus and hepatitis C virus infection, Alpha-foetoprotein mRNA and some surgical factors. Treatment strategies include re-resection, transarterial chemoembolization, radiofrequency ablation, percutaneous ethanol injection, salvage liver transplantation, radioactive seed 125I implantation and other new treatment modalities of postoperative recurrent HCC are all used to prolong survival in patients with recurrence, and multimodality therapy of above mentioned therapies may offer additional beneﬁt.
  
  
  CONCLUSIONS
  With advances in perioperative detection and therapeutic modalities, results of recurrence after resection of HCC will greatly improved.
authors.forename: Fenge
authors.initials: F
authors.lastname: Li
authors.forename: Zhi
authors.initials: Z
authors.lastname: Guo
authors.forename: Haitao
authors.initials: H
authors.lastname: Wang
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local / Q000628:therapy*