Hepatocellular carcinoma (HCC) is a common malignancy, and its incidence is expected to
increase in many countries in coming decades. Though prognosis for patients with HCC is
generally poor, hepatic resection can be an effective curative treatment, and its indications
have been expanding in recent years. Resection can be reasonably safe and effective even for
patients with micro- or macrovascular invasion. However, the recurrence rate of HCC is as
high as 74% for patients with intermediate and advanced HCC after resection. Microvascular
invasion is one of the main risk factors which influence risk of HCC recurrence and patient
prognosis after resection. Therefore, adjuvant therapy to prevent tumor recurrence after
resection is so important to improve patient prognosis.
Nowadays, adjuvant transarterial chemoembolization (TACE) is reported to be effective in
reducing early recurrence rate and mortality for patients with HCC with risk factors of
recurrence. Sorafenib is a novel drug which is effective for advanced stage HCC. However, the
efficacy of adjuvant sorafenib for postoperative HCC is unknown. Therefore, it is interesting
to investigate the efficacy of adjuvant sorafenib, and compare its efficacy to TACE, TACE
plus sorafenib, or best supportive care for patients with postoperative HCC and microvascular
invasion.