Abstract: Objective To investigate the efficacy and prognosis of systemic drug therapy in patients with tumor recurrence after radical resection of HBV-related liver cancer, and analyze its influencing factors. Methods For 43 patients who relapsed after radical resection of liver cancer were finally included, baseline demographic data and clinical data were collected. After receiving systemic drug treatment, the curative effect was evaluated based on the RECIST 1.1 standard; the COX regression model was used to analyze the PFS and PFS of HCC patients. Influencing factors of OS, the survival curve was drawn by Kaplan-Meier method. Results The curative effect evaluation results of the entire group of patients showed that there were 7 patients with PD, 10 patients were PR, and the remaining 26 patients were SD. Univariate analysis showed that HBV DNA-positive patients and patients with tumor stage BCLC C stage affected PFS (P<0.05). OS-based analysis showed that ascites HR (95% CI): 2.700 (1.058~6.889), P=0.038; HBV DNA positive HR (95% CI): 2.873 (1.030~8.012), P=0.044; AFP highly expressed HR (95% CI): 4.753 (1.404~16.086), P=0.012; tumor stage BCLC stage C HR (95% CI): 7.753 (2.365~25.414), P=0.001; these factors all reduce the patient's survival . Among them, patients with BCLC stage C before surgery have the worst prognosis and are independent risk factors. Conclusion Patients with ascites, HBV DNA-positive, and late preoperative tumor staging often indicate a poor prognosis for systemic drug therapy, suggesting that such patients should be actively treated with comprehensive systemic treatment after radical surgery to improve their prognosis.

Key words: Hepatitis B virus, Hepatocellular carcinoma, Radical operation, Recurrence, Systemic drug therapy