Patients who have undergone hepatectomy as treatment for hepatocellular carcinoma frequently experience disease recurrence within the first year after surgery. It has been speculated that this could be caused by circulating cancer stem cells (CSCs) that have escaped from the tumor prior to resection. Therefore, it is possible that measuring the levels of these CSCs could be used to determine the likelihood of recurrence. Indeed, a recent study has shown that patients with a higher than median level of CSCs had a higher rate of recurrence than those with CSC levels below the median. This CSC-based prediction was an independent prognostic marker for recurrence-free survival and could potentially be used to help determine the appropriate level and type of post-surgery therapy.