BACKGROUND: Four tumor markers for hepatocellular carcinoma(HCC), alpha-fetoprotein(AFP), glypican-3(GPC3), vascular endothelial growth factor(VEGF) and des-gammacarboxy prothrombin(DCP), are closely associated with tumor invasion and patient’s survival. This study estimated the predictability of preoperative tumor marker levels along with pathological parameters on HCC recurrence after hepatectomy.METHODS: A total of 140 patients with HCC who underwent hepatectomy between January 2012 and August 2012 were enrolled. The demographics, clinical and follow-up data were collected and analyzed. The patients were divided into two groups: patients with macroscopic vascular invasion(Ma VI +) and those without Ma VI(Ma VI-). The predictive value of tumor markers and clinical parameters were evaluated by univariate and multivariate analysis.RESULTS: In all patients, tumor size(>8 cm) and Ma VI were closely related to HCC recurrence after hepatectomy. For Ma VI+ patients, VEGF(>900 pg/m L) was a significant predictor for recurrence(RR=2.421; 95% CI: 1.272-4.606; P=0.007). The 1- and 2-year tumor-free survival rates for Ma VI+ patients with VEGF ≤900 pg/m L versus for those with VEGF >900 pg/m L were 51.5% and 17.6% versus 19.0% and 4.8%(P<0.001). For Ma VI- patients, DCP >445 m Au/m L and tumor size >8 cm were two independent risk factors for tumor recurrence(RR=2.307, 95% CI: 1.132-4.703, P=0.021; RR=3.150, 95% CI: 1.392-7.127, P=0.006; respectively). The 1- and 2-year tumor-free survival rates for the patients with DCP ≤445 m Au/m L and those with DCP >445 m Au/m L were 90.4% and 70.7% versus 73.2% and 50.5% respectively(P=0.048). The 1-and 2-year tumor-free survival rates for the patients with tumor size ≤8 cm and >8 cm were 83.2% and 62.1% versus 50.0% and 30.0%, respectively(P=0.003).CONCLUSIONS: The Ma VI+ patients with VEGF ≤900 pg/m L had a relatively high tumor-free survival than those with VEGF >900 pg/m L. In the Ma VI- patients, DCP >445 m Au/m L and tumor size >8 cm were predictive factors for postoperative recurrence. BACKGROUND: Four tumor markers for hepatocellular carcinoma (HCC), alpha-fetoprotein (AFP), glypican-3 (GPC3), vascular endothelial growth factor (VEGF) and des-gammacarboxy prothrombin (DCP) survival. This study estimated the predictability of preoperative tumor marker levels along with pathological parameters on HCC recurrence after hepatectomy. METHODS: A total of 140 patients with HCC who underwent hepatectomy between January 2012 and August 2012 were enrolled. The demographics, clinical and follow- The patients were divided into two groups: patients with macroscopic vascular invasion (Ma VI +) and those without Ma VI (Ma VI-). The predictive value of tumor markers and clinical parameters were evaluated by univariate and For Ma VI + patients, VEGF (> 900 pg / m L) was a multivariate analysis .RESULTS: In all patients, tumor size (> 8 cm) and Ma VI were closely related to HCC recurrence after hepatectomy. The 1- and 2-year tumor-free survival rates for Ma VI + patients with VEGF ≤ 900 pg / m L versus for those with (p = 0.007) For Ma VI-patients, DCP> 445 m Au / m L and tumor size> 8 cm were two independent risk factors (P <0.001) for tumor recurrence (RR = 2.307, 95% CI: 1.132-4.703, P = 0.021; RR = 3.150, 95% CI: 1.392-7.127, P = 0.006; respectively). The 1- and 2-year tumor- Rates for the patients with DCP ≤445 m Au / m L and those with DCP> 445 m Au / m L were 90.4% and 70.7% versus 73.2% and 50.5% respectively (P = 0.048). The 1-and 2-year tumor-free survival rates for the patients with tumor size ≤8 cm and> 8 cm were 83.2% and 62.1% versus 50.0% and 30.0%, respectively (P = 0.003) .CONCLUSIONS: The Ma VI + patients with VEGF ≤900 pg / m L had a relatively high tumor-free survival of those with VEGF> 900 pg / m L. In the Ma VI-patients, DCP> 445 m Au / m L and tumor size> 8cm were predictive factors for postoperative recurrence.