Abstract: Objective: To discuss the prognostic factors of patients with recurrent hepatocellular carcinoma following the second resection of cancer. Methods:Clinico-pathologic data and follow-up records of 41 patients with recurrent hepato-cellular carcinoma, who underwent re-excision, were retrospectively reviewed in this study. Kaplan-Meier curve and log-rank test were used for univariate analysis of the 23clinico-pathologic variables, and then multivariate analysis was conducted using the COX proportional hazard regression model. In addition, the one-factor analysis of variance was conducted to compare the amount of blood loss and the time of surgery in the surgical procedures. Results: The 1-, 3- and 5-year overall survival rates of the 41 patients undergoing the second excision of cancer were 68% ,36% and35% , respectively, while the 1-, 3- and 5-year disease-free survival rates of the patients were 39% ,22% and 7% , respectively. The independent prognostic factors affecting the survival rates include: (i) portal vein tumor thrombus in the first hepatectomy; (ii) diameter of the liver cirrhosis nodule in the first hepatectomy; (iii) the scope of surgical margin in the second hepatectomy, and (iv) postoperative adjuvant therapy after re-excision. No independent prognostic factor influencing the recurrence-free survival rates was obtained. There were no significant differences in the intra-operative blood loss amount and the operation time among the surgical procedures. Conclusion : The prognosis after re-excision is poor in patients with portal vein tumor thrombus or bigger diameter of the cirrhosis nodule in the first surgery. In the second surgery, the scope of the surgical margin of liver over 1cm or postoperative adjuvant combined therapy may improve the prognosis of the patients.