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Page 4 of 6 Zhong et al. Hepatoma Res 2019;5:18 I http://dx.doi.org/10.20517/2394-5079.2019.01

China, nearly 90% patients with HCC are infected with HBV. In addition, many of them have liver cirrhosis,
[38]
show microvascular invasion or micrometastases before hepatectomy . Therefore, almost each patient
with HCC presents risk factors for early- and/or late-phase tumor recurrence. Adjuvant therapy for patients
should be take into account the risk factors that they possess. Individuals presenting several such risk factors
may benefit most from combination treatment modality dedicated to against both early- and late-phase
tumor recurrence. However, few trials have investigated the safety and efficacy of combinated therapies. This
content is urgently needed for further trials. They should think over the full profile of prognostic risk factors
in included individuals so that ensure that individuals with similar risk factors are assigned the appropriate
combination therapy.

In summary, official guidelines have been shown to be clinically useful for guiding research and treatment
of HCC [13,14] . Nevertheless, despite the sometimes substantial evidence indicating the safety and efficacy of
adjuvant therapies for specific patients, official guidelines do not recommend them as treatment options [13,14] .
More and more worldwide studies suggest that (1) hepatectomy could be a suitable treatment for selected
patients with intermediate or advanced stage HCC, as long as preserved liver function is adequate; and (2)
adjuvant transarterial chemoembolization for individuals with high risk of early-phase recurrence, NAs for
individuals with HBV-related HCC, and interferon-α for individuals with HCV-infected HCC, are associated
with better OS. There is now room, rather than debating whether or not hepatectomy and adjuvant therapies
should have a room for these individuals, for focusing better on selection criteria to further enhance the
long-term benefits of hepatectomy and adjuvant therapies.

DECLARATIONS
Authors’ contributions
Conceived the study: Xiang BD
Wrote and reviewed the manuscript: Zhong JH, Xiang BD

Availability of data and materials
Not applicable.

Financial support and sponsorship
This work was supported by the National Major Special Science and Technology Project (2017ZX10203207),
Graduate Course Construction Project of Guangxi Medical University (YJSA2017014), the Foundation
Ability Enhancement Project for Young Teachers in Guangxi Universities (2018KY0122), the Guangxi
Natural Science Foundation (2018GXNSFBA138018), and Guangxi BaGui Young Scholars.

Conflicts of interest
Both authors declared that there are no conflicts of interest.

Ethical approval and consent to participate
Not applicable.

Consent for publication
Not applicable.

Copyright
© The Author(s) 2019.

REFERENCES
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mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2018;68:394-424.