Prevention of recurrence after curative treatment for hepatocellular carcinoma

Hepatocellular carcinoma often recurs even after curative treatment. In addition to its high frequency of metastasis, hepatocellular carcinoma recurrence is characterized by multicentric carcinogenesis arising in the liver damaged by viral infection with the hepatitis B or hepatitis C virus. This is considered to complicate the initial treatment and recurrence prevention strategy for hepatocellular carcinoma, and accordingly, there is no established adjuvant therapy to prevent recurrence. Preventive adjuvant therapy should be administered to high-risk patients, and should be optimized based on individual risk factors. This review will summarize the current status and future prospects of preventive therapy for the recurrence of hepatocellular carcinoma after curative treatment. Although transcatheter arterial embolization/chemoembolization prior to curative treatment can induce tumor necrosis in some patients, several studies have failed to show any improvement in survival. Postoperative interferon therapy may contribute to prolonging the survival in specific groups of patients. No established adjuvant therapy against advanced hepatocellular carcinoma that prevents metastasis has been established so far. Novel treatment strategies incorporating molecular and immunological mechanisms are expected in the future.