**5. Conclusion**

The principles of therapy for recurrent HCC should be, in fact, the same as those for primary HCC. Patients should have proper pre-operative assessment for their general functional status and evaluation of the functional liver reserve. Active hepatitis seems to be an important factor for patients considered for repeated liver resection, and therefore viral status, viral activity and finally liver function have to be evaluated thoroughly before resection. Depending on the local availability of various imaging modality, detail workup for restaging the disease and to rule out extra-hepatic metastasis is an important part in the decision of the best treatment for patient with recurrent HCC. Re-hepatectomy should be the treatment of choice if the tumour is resectable in terms of patient's performance status, tumour staging and functional reserve of the liver remnant. For patients with small recurrence and borderline liver functional, local ablation therapy is a safe and effective treatment option. In case of multiple intra-hepatic recurrences, TACE can be considered in patients with good liver function as long as the portal veins remain patent.
