摘要BACKGROUND: Four tumor markers for hepatocellular car-cinoma (HCC), alpha-fetoprotein (AFP), glypican-3 (GPC3), vascular endothelial growth factor (VEGF) and des-gamma-carboxy prothrombin (DCP), are closely associated with tumor invasion and patient’s survival. This study estimated the predict-ability of preoperative tumor marker levels along with patho-logical parameters on HCC recurrence after hepatectomy. <br> 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 (MaVI +) and those without MaVI (MaVI-). The predictive value of tumor markers and clinical parameters were evaluated by uni-variate and multivariate analysis. <br> RESULTS: In all patients, tumor size (>8 cm) and MaVI were closely related to HCC recurrence after hepatectomy. For MaVI+ patients, VEGF (>900 pg/mL) was a signiifcant predic-tor for recurrence (RR=2.421; 95% CI: 1.272-4.606;P=0.007). The 1- and 2-year tumor-free survival rates for MaVI+ pa-tients with VEGF≤900 pg/mL versus for those with VEGF>900 pg/mL were 51.5% and 17.6% versus 19.0% and 4.8%(P<0.001). For MaVI- patients, DCP >445 mAu/mL and tumor size >8 cm were two independent risk factors for tumor recur-rence (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 mAu/mL and those with DCP >445 mAu/mL 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 tu-mor size≤8 cm and >8 cm were 83.2% and 62.1% versus 50.0%and 30.0%, respectively (P=0.003). <br> CONCLUSIONS: The MaVI+ patients with VEGF≤900 pg/mL had a relatively high tumor-free survival than those with VEGF >900 pg/mL. In the MaVI- patients, DCP >445 mAu/mL and tumor size >8 cm were predictive factors for postopera-tive recurrence.