Abstract
Until near 1980s the mortality and survival rates after hepatectomy for hepatocellular carcinoma (HCC) were dismal in Japan. But the recent management strategies including preoperative assessment of hepatic functional reserve and technological advances unproved the results of surgical treatment, Early detection due to radiological advancements also contributed to the improved prognosis and a 5-year survival rate of 40% to 50% has been reported in recent series. However, because of biological tumor characteristics and combined chronic liver diseases the rate of recurrence is still very high. Vascular invasion and intrahepatic metastasis are the most important biological characteristics of HCC and related tumor recurrences. Multicentric occurrence is also important as another type of recurrence especially in cirrhosis, Hence prevention and effective management of recurrence are undoubtly the most significant strategies to improve the overall survival. Although multidisciplinary treatment modalities contributed to the improved prognosis, long term prognosis is still unsatisfactory. Therefore the eradication of hepatic virus infections (HBV, HCV) and the treatment of chronic liver disease before its turns into cirrhosis and cancer seem to e essential.
