Second hepatic resections (SHR) were performed in 2 patients with recurrent hepatocellular carcinoma (HCC) with hepatitis C virus (HCV) more than 10 years after initial curative resections. Appearance on imaging studies of the late recurrences thought to be multicentric primary tumors, was preceded by fluctuating laboratory abnormalities such as increased alanine aminotransferase activity (ALT), increased serum alpha-fetoprotein (AFP), and decreased platelet counts by as long as 2 years. Therefore, serial changes of blood tests after resection of HCC with HCV might be useful predictors of late multicentric recurrence.