“…10,11,[22][23][24][25] Early recurrence is generally correlated with understaging, 4,10,25-28 incomplete tumor excision, 11,[25][26][27][29][30][31][32] or multiple tumor cell dissemination inside or outside the liver through the portal venous system 33 during surgical manipulation of the tumorous livers. 4,13,34,35 Microscopic residual disease in the remaining liver can develop soon after LR, partly because resection itself leads to regeneration and is the most potent growth stimulus for liver-derived cells known to date. 26 Because the regeneration process is unable to affect the diseased parenchyma in a patient with cirrhosis, 36 a growth response can only be expected in the neoplastic hepatocytes.…”