Analysis of the recurrence risk factors for the patients with hepatocellular carcinoma meeting University of California San Francisco criteria after curative hepatectomy

Introduction
Hepatocellular carcinoma (HCC) is one of the most common cancers worldwide, especially in the Asia pacific area [1]. Liver transplantation is theoretically the best option because it cures both the tumor and the underlying liver disease. The overall survival rate at 5 years after liver transplantation was around 70-75% [2]. In contrast, 5-year survival rates after liver resection were only 40% to 65%, and the 10-year survival rate was 29%. The high incidence of HCC recurrence following liver resection is a serious issue. The recurrent rate is as high as 50-60% at 3 years and 70-100% at 5 years. This high recurrent rate precludes long-term tumor-free survival of the patients with liver resection for HCC. However,
liver transplantation is limited by a shortage of graft availability. Liver ransplantation also has high perioperative risk, and long-term problems such as graft rejection and infections[3]. Therefore, liver resection is still the primary selection treatment for many HCC patients, especially in areas lacking deceased liver.