“…26 ACC with extension into the renal vein, vena cava, or right atrium may require thrombectomy, cardiopulmonary bypass, hepatectomy for local spread or exposure, and vena cava reconstruction. 43,44,68,69 At the time of recurrence, surgery is recommended for patients with favorable prognostic factors, including a disease-free interval from previous surgery that is longer than 6 to 12 months, and achievable R0 resection. 31,32,40,[50][51][52] If not possible, surgery may be reconsidered at the time of objective response.…”