Journal of

Hepatocellular carcinoma (HCC), the sixth most common cancer and the third leading cause of cancer deaths worldwide, remains a major health concern. Recurrence occurs in up to 70% of cases within five years post-surgery, underscoring the need for better management strategies. Despite advancements in surveillance, detection, and treatment, such as surgical resection, liver transplant, and local ablative therapy, the prognosis remains poor. This persistent risk underscores the need for improved strategies in surgical patient selection, prognostic stratification, and postoperative management. Alpha-fetoprotein (AFP), long regarded as a diagnostic and surveillance biomarker, has gained renewed attention for its dynamic role in predicting outcomes after surgical intervention. Recent studies, including one performed by Song et al., highlight the importance of recurrent AFP (r-AFP) kinetics in patients undergoing repeat hepatectomy. Their results show a substantial correlation between r-AFP positivity and a worse recurrence-death survival rate, indicating that AFP dynamics offer useful information beyond static baseline measures.