Abstract:Objective: To analyze the recurrence profiles of the hepatitis C virus-related hepatocellular carcinoma (HCV-HCC) after radical resection and the risk factors, and discuss the individualized clinical interventions for different recurrent phases. Methods: The clinicopathologic data of 98 HCV-HCC patients undergoing radical resection were reviewed. The recurrence profiles of these patients after radical resection were analyzed, and the risk factors for recurrence were determined by both univariate and multivariate analysis. Moreover, the viral factor was evaluated using stratified analysis. Results: Two peaks of recurrence after radical resection were observed in the entire group of patients, and demarcation point between the early and late recurrence was at postoperative 24 months. COX proportional hazards regression model indicated that the low differentiation of tumor cells and microscopic vascular invasion were independent risk factors for early recurrence (P<0.001), whereas, the viral load was the independent risk factor for late recurrence (P=0.013). Further stratified analysis indicated that the patients with sustained negative viral load after surgery had a significantly longer tumor-free survival time than those with sustained high viral load or unstable viral load after surgery (P<0.001). Conclusion: Different risk factors are responsible for the early and late recurrence after HCV-HCC redical resection. Early recurrence is relatively high, and the postoperative prophylactic TACE may improve the tumor-free survival in early recurrence high-risk patients, while postoperative antiviral therapy may improve long-term outcomes of the patients.