With respect to the 2nd recurrence after treatment of the IDR, male sex (H.R. = 1.47, 95% CI(1.10–1.97), p = 0.01), age greater than 65 years (H.R. = 1.73, 95% CI(1.28–2.30), p = 0.006), an AFP level greater than 20 ng/ml (H.R. = 1.52, 95% CI(1.14–2.04), p = 0.004), tumor number greater than 1 (H.R. = 1.35, 95% CI(1.01–1.81), p = 0.046), and IDR developing within 2 years (H.R. = 1.66, 95% CI(1.23–2.24), p = 0.001) were associated with higher risks of 2nd recurrence while surgical treatment for IDR resulted in lower risk of 2nd recurrence (H.R. = 0.25, 95% CI(0.09–0.68), p = 0.007). The gene discussed is AFP; the disease is neoplasm.