Background : Hepatocellular carcinoma (HCC) is the sixth most common cancer and the most frequent cause of cancer related deaths worldwide. The 5 year recurrence rates are up to 70% across studies. For patients with extrahepatic metastasis the median survival is 9.6 months and the overall 1-, 3-, 5-year survival rates are 31%, 7% and 4% respectively. Patients with distant metastases are often treated with palliative care.

Methods : We present the case long-term survival of patient with late stage HCC who underwent 4 times surgery for advanced HCC, 3 times TACE for the reccurence, 1 radiation therapy and target treatment for distance metastasis.

Results : After 5 years of this multi-stage treatment, the patient has no active tumor and continues to be monitoring

Conclusions : - Multidisciplinary team care management can improved overall survival who diagnosed advanced late stage HCC - Distant metastasis for HCC is not excluding criteria for liver surgery. It can depends on target and radiation treatment result and cancer differentiation.