Department of Hepatobiliary Surgery, Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, China.
Postoperative recurrence of hepatocellular carcinoma (HCC) has a negative impact on long-term survival. According to available evidence, many systemic untargeted agents are ineffective as adjuvant therapy to prevent the recurrence of HCC following curative resection. Interferon α has potential effectiveness as adjuvant therapy for HCC in the presence of underlying conditions such as HBV or HCV infection. Oral polyprenoic acid has also proven its effectiveness according to a prospective study; however, no other studies have reported polyprenoicacid (acyclic retinoid) to be effective. Sorafenib is the only systemic molecular targeted agent that has proven effectiveness as adjuvant therapy according to a pilot study. To date, 11 randomized clinical trials are underway with different agents as adjuvant systemic drug therapy to prevent the recurrence of HCC following curative resection according to Clinicaltrial.gov. Adjuvant systemic drugs may be the most promising of all adjuvant modalities in the near future since HCC may be a systemic disease rather than a local disease.