At present, liver cancer mainly undergoes comprehensive treatment based on surgical resection. In addition to surgery, comprehensive treatment also includes chemotherapy and targeted drug therapy. Among them, chemotherapy is a very important part of the comprehensive treatment for liver cancer patients. It should be emphasized that not all liver cancer patients need chemotherapy because some patients have small tumors that can be basically cured after resection, or their AFP levels can be reduced to normal after surgery, so such patients can completely avoid chemotherapy. Whether a patient needs chemotherapy after surgery depends on the pathological test results after surgery, the recovery of the body and the results of the review. Patients who need chemotherapy are roughly of the following categories: first, patients with relatively large liver tumors; second, patients with high alpha-fetoprotein values (AFP) found in postoperative examinations; third, patients whose pathological results show that the tumor has invaded blood vessels, whether it is the right or left branch of the secondary portal vein, or the small vessels at the edge of the tumor, or cancerous thrombus (visible under microscope) seen inside the small veins, as long as the pathology department finds cancerous thrombus in the specimen vessels Fourth, young patients, because the metabolism of these patients is faster, so the tumor will grow rapidly and the malignancy of the tumor will be relatively high, I generally recommend patients under 40 years old to insist on chemotherapy. Sixth, patients who have recurrence soon after surgery and cannot be reincised immediately, so they can only consider other treatments, such as radiofrequency ablation or chemotherapy; seventh, patients whose pathology report shows positive cutting edge, indicating that the tumor is not cut cleanly, which is rare, but chemotherapy is needed even if it is found; eighth, patients whose pathology report shows that liver cancer has lymph node metastasis. The final pathological examination results are particularly important in determining whether a patient needs chemotherapy. There have been cases in which the patient’s pathological examination did not find cancer cells or judged that it was not liver cancer, so chemotherapy and other treatments were not selected after surgery, but the liver cancer recurred after a period of time on review. Therefore, accurate pathological examination results are crucial to what treatment a patient should take. Sometimes I would suggest patients to get the pathology results and then take the pathology specimens (which can be requested from the pathology department of the hospital) to other hospitals for consultation. However, some liver cancer patients are also really intolerant to chemotherapy, such as those who are in poor physical condition, not recovering particularly well after surgery, or those who experience severe adverse effects after chemotherapy, and the use of chemotherapy drugs would be too harmful to them, so chemotherapy is not recommended for these patients. In this case, some basic treatments are needed to ensure patients’ quality of life, and if their physical condition improves, chemotherapy can be considered again in the future. For liver cancer patients who have undergone liver transplantation, my recommendation is to have preventive chemotherapy, as liver cancer can easily recur or metastasize if chemotherapy is not done after liver transplantation.