Chen ZH, Zhang XP, Feng JK, et al. - In cases of hepatocellular carcinoma (HCC) with microvascular invasion (MVI), tumor recurrence after hepatectomy was shown to have unique features and recurrence patterns. Improved long-term survival outcomes were achieved by early detecting tumor recurrence and with repeat liver resection with curative intent.

• This is an analysis of a multicenter database of patients with HCC and MVI who underwent resection; a total of 1,517 patients with median follow-up of 39.7 months were included.

• Overall 928 patients suffered tumor recurrence; 49% within 6 months of hepatectomy and 60% only in the liver, and a slow increase in the incidence of intrahepatic only recurrence was evident with time after 6 months.

• Worse survival outcomes were experienced by patients who had recurrence within 6 months of hepatectomy vs those who developed recurrence later.

• Better prognosis was reported for those with intrahepatic only recurrence vs those with either extrahepatic only recurrence or those with intra- and extrahepatic recurrence.

• Better results were obtained with repeat resection of recurrence with curative intent vs other treatment approaches.