Mao K, et al. - In this retrospective study using propensity score matching and multiple imputation, researchers evaluated overall and cancer-specific survivals (OS and CSS) among hepatocellular carcinoma patients (HCCs) with extrahepatic metastases with resectable primary tumors who either underwent or did not undergo primary tumor resection (PTR) in the SEER registry between 2004 and 2013. For validation, another cohort from the Sun Yat-sen Memorial Hospital (SYSMH) was included. PTR was found to be related to improved OS and CSS. These improvements continued to be significant following sensitivity analyses using multiple imputation. A correlation of PTR with improved OS and CSS was shown in the validation cohort from the SYSMH (n = 131). Overall, a favorable influence of PTR on the prognosis of HCCs with extrahepatic metastases with resectable primary tumors, was seen.