肝细胞癌 (HCC) 复发包括癌症扩散导致的真正复发和同一易患癌症的肝脏内新发肿瘤，约 70% 的病例在 5 年时间内会出现并发症。新辅助治疗对肝细胞癌肝切除术后复发的疗效尚不清楚。我们报道一例复发性大块晚期肝细胞癌，采用连续肝动脉灌注化疗（HAIC）和序贯经导管动脉栓塞（TAE）联合二次手术治疗，病理完全缓解。切除1个月后，患者复发（肿块型141mm×76mm）。 4次HAIC序贯TAE转换治疗后，肿瘤明显缩小（70mm×29mm），甲胎蛋白（AFP）和维生素K缺乏或拮抗剂-II诱导蛋白（PIVKA-II）水平明显下降，残余肝脏体积明显下降。左半肝占标准肝体积的39.85%(左半肝右前叶占标准肝体积的80.17%]吲哚菁绿15分钟保留(ICG R15 8.0%)符合手术要求。第二次手术为进行，肝血流阻断后肿瘤完全切除的要求。术后病理结果显示肿瘤完全缓解（PCR），随访16个月未发现复发。本例中，HAIC序贯TAE转换疗法对肝细胞癌术后复发患者近期疗效良好，肿瘤负荷显着减轻，二次手术病理达到完全缓解，安全性和耐受性良好，值得研究和推广。 © 2023 陈等人。

Hepatocellular carcinoma (HCC) recurrence, which encompasses both true recurrence resulting from cancer spread and de novo tumors developing within the same cancer-prone liver, presents a complication in approximately 70% of cases within a 5-year timeframe. The efficacy of neoadjuvant therapy for recurrence after hepatectomy for hepatocellular carcinoma is still unclear. We report a case of recurrent massive advanced hepatocellular carcinoma with pathological complete remission was treated by continuous hepatic arterial infusion chemotherapy (HAIC) and sequential transcatheter arterial embolization (TAE) combined with secondary operation. One month after resection, the patient recurred (massive type 141mm×76mm). After 4 times of HAIC sequential TAE conversion therapy, the tumor shrank significantly (70mm×29mm), alpha-fetoprotein(AFP) and protein induced by vitamin K absence or antagonist-II (PIVKA-II) levels decreased significantly, residual liver volume[left half liver accounted for 39.85% of standard liver volume(left half liver + right anterior lobe) accounted for 80.17% of standard liver volume] and Indocyanine green 15-minute retention(ICG R15 8.0%) complies with surgical requirement.The second operation was performed, and the tumor was completely resected after hepatic blood flow occlusion Requirement. The postoperative pathological results showed complete remission (PCR) of the tumor, and no recurrence was found during the follow-up of 16 months. In this case, HAIC sequential TAE conversion therapy has good short-term effect on patients with postoperative recurrence of hepatocellular carcinoma, tumor burden is significantly reduced, the second surgery pathology achieves complete remission, safety and tolerance, it is worthy of study and promotion.© 2023 Chen et al.