Introduction: Hepatocellular carcinoma is one of the most common cancers in the world. The best curative treatment for hepatocellular carcinoma is liver resection. However, it has been known that there is a high possibility of recurrence if there is cirrhosis even after liver resection. Some studies recently explored the differences between early and late recurrence and investigated the risk factors for each type of recurrence. Predictive factors for early recurrence, i.e. recurrence within 24 months of surgery , are well established and are mainly tumor- and treatment related (i.e. tumor size, tumor number, presence of microsatellites, and vascular invasion). By contrast only poor data are available for the drediction of late recurrence, io.e. recurrence 24 months post-surgery, which is probably related to the evolution of the underlying chronic liver disease. Among the possivle predictive factors for late HCC recurrence, the presence and the degree of portal hypertension(PH) could play an important role. In the last decede, several authros have tried to assess PH with non-invasive methods.in particular the role of liver stiffness have been investigated as non-invasive marker of PH and its complication.Generally, transient elastography (TE) used for liver stiffness measurement (LSM) for a long time. In addition to TE, magnetic resonance elastography (MRE) has emerged as another non-invasive method to evaluated liver fibrosis. MRE has advantages over TE including the acquisition of images that can be referred for LSM and a larger sampling area. Owing to these theoretical merits of MRE over TE, MRE provided significantly better performance in assessing liver fibrosis than TE in previous studies.

Method: Between January 2014 and December 2018, 603 patients underwent Hepatic resection (HR) for HCC. Among 603 patients, 245 patient checked MRE, but 5 cases had technical failure. We analyzed 241 patients. HCC recurrence was defined the recent AASLD guidelines as early (if occurring <24 months) or late (if occurring >24 months). The follow-up protocol included a clinical assessment by physical examination, US and laboratory exams every 3 months. HCC recurrence was diagnosed according to modifications of alpha-fetoprotein levels and US appearance, confirmed either by multiphasic CT or multiphasic MRI. Clinical data were analyzed disease-free survival rate (DFSR) according to serum alpha-fetoprotein (AFP) level, Magnetic resonance elastography (MRE).

Result: Between January 2014 and December 2018, HR for HCC group has incidence of recurrence is 40.2% (97/241). Early recurrence rate is 22.0% (53/241) rate recurrent rate is 18.3% (44/241).

Conclusion: Magnetic resonance elastography that measure liver fibrosis predict de novo recurrence after hepatic resection for hepatocellular carcinoma. So we consider liver transplantation in severe stiffness liver parenchyma.