Hepatocellular carcinoma (HCC) is one of the most commonly diagnosed malignancies in China. Seventy percent of HCC occurred secondary to hepatitis and cirrhosis. It is now available to discover HCC in an early stage due to advanced technology in diagnosis. However, most cases, which are diagnosed definitely as HCC, are in advanced stage. Hepatectomy is the most commonly treatment for HCC. In some advanced HCC, which not available for hepatectomy initially, down-stage treatments such as transarterial chemo-embolization, systemic chemotherapy can converse tumors to resectable HCC. Then salvage hepatectomy can be done to prolong patients' survival. In some cases which are considered unresectable because of small remnant liver volume, curative resection can be attempted after future liver remnant volume enlarged by two-stage techniques like PVE and ALPPS. Frequent intrahepatic tumor recurrence is a crucial event response for poor prognosis in HCC. Repeated treatments are recommended without hurting maintained liver function after local-regional therapy. Compared with ablation, transarterial chemoembolization and other local treatments, hepatectomy provides the best long-term outcomes. Hepatectomy combining with different treatments and repeated therapies can obtain a good overall survival. Hepatectomy should be positively used in advanced and recurrent hepatocellular carcinoma. [ABSTRACT FROM AUTHOR]