Abstract: Objective To explore the effect of primary tumor location or combined with serum AFP on the prognosis and postoperative recurrence for patients with hepatocellular carcinoma. Methods A total of 256 patients,who underwent routine surgery and with long term follow-up from March 2005 to October 2009,were retrospectively analyzed in our study.Kaplan-Meier survival curve was used to analyze overall survival(OS) and time to recurrence(TTR) and Logrank test was used to calculate P values.Univariate and multivariate analysis of clinicopathological parameters in hepatocellular carcinoma(HCC) patients with postoperative recurrence were carried out by Cox-regression analysis. Results There was different in overall survival of HCC patients based on their primary tumor location(P=0.022).Furthermore,the group with left or double hepatic lobe tumor demonstrated a higher recurrence risk than that of patients in the group with right hepatic lobe tumor(P=0.002).In a stratified analysis,there was a significant difference in the postoperative recurrence rate under the subset of negative serum AFP(AFP<25 ng/ml)(P<0.001),whereas no difference in the subset of positive serum AFP(AFP≥25 ng/ml)(P=0.258).Univariate and multivariate analysis showed that metastasis,serum AFP and Portal vein tumor thrombus(PVTT) were 3 dependent recurrent risk factors,whereas primary tumor location was not. Conclusion Primary tumor location can be served as an important recurrent risk factor in HCC patients after hepatectomy.