The increased pulmonary metastatic nodules were found in the palliative resection group (14.3 ± 4.7) compared to controls (8.7 ± 3.6), which may be partially due to breakdown of tumor MMP2/TIMP2 balance and in situ up-regulation of VEGF that was consistent with a recent report that confirmed increased VEGF transcription in residual HCC after hepatectomy in a small animal model [25]. This evidence concerns the gene VEGFA and hepatocellular carcinoma.