An article on the surgical treatment and prognosis of women with hepatocellular carcinoma was published online by Dr. Tao Li, deputy chief of the Department of General Surgery at Qilu Hospital, Shandong University, in the leading American surgical journal Surgery. Due to the protective effect of estrogen, women have a lower risk of hepatitis B and hepatocellular carcinoma than men, but with the change of women’s lifestyle in recent years, the rate of hepatocellular carcinoma in women has increased and the prognosis is poor. This study systematically explored the clinicopathological characteristics of 459 female hepatocellular carcinoma patients who underwent surgical resection, and analyzed the effects of age and estrogen levels on the prognosis and risk factors for recurrence after surgical resection. However, estrogen only improves survival in early stage female hepatocellular carcinoma patients, but not in advanced stage female hepatocellular carcinoma patients. Although a higher percentage of female hepatocellular carcinoma patients have elevated AFP, the level of AFP in female hepatocellular carcinoma patients does not reflect the prognosis of patients. Vascular invasion and GGT levels are risk factors for early postoperative recurrence in female patients, whereas AFP and GGT levels are risk factors for late recurrence in female hepatocellular carcinoma patients. These innovative findings are of great clinical value to improve the prognosis of female liver cancer patients and to determine their risk of postoperative recurrence and metastasis.