A systematic review demonstrated that the failure rate of TSH ranged 0%‐36% (median, 23%), the main reason for failure being disease progression after first‐stage surgery.59 We previously reported a failure rate of 35.2%, and main reason was disease progression after first‐stage surgery (88.6%).60 In this study, four independent predictive factors for the failure of TSH were identified, namely tumor progression while on first‐line chemotherapy, number of chemotherapy cycles >12, tumor size >40 mm, and carcinoembryonic antigen at hepatectomy >30 ng/mL. This evidence concerns the gene CEACAM5 and neoplasm.