Prevention of hepatocellular carcinoma recurrence: actuality and perspectives

Postsurgical recurrence of hepatocellular carcinoma is frequent and fatal. Various adjuvant treatments to possibly prevent recurrence have been recommended, which seem to depend on expectation rather than evidence. Up to now, randomized controlled trials have been conducted to clarify the clinical effect of the 4 therapeutic options including acyclic retinoid, 131I-lipiodol, adoptive immunotherapy, and interferon. We have recently demonstrated that adoptive immunotherapy is a safe, feasible treatment that can reduce the risk of recurrence and improve recurrence-free outcomes. Actually all the options reduced in part the recurrence but had drawbacks in the their effectiveness, and large trials are needed to assess other important endpoints, such as clinical feasibility, risk-benefit and cost-effectiveness. Recurrence control of hepatocellular carcinoma is the clinical priority, and we are approaching this goal.