Primary liver cancer cases are increasing rapidly, demanding enhanced screening and surgical readiness.

• Incidence and deaths have surged 59.4% and 55.8% from 2000 to 2023, respectively.
• Hepatitis B and C remain key causes, but rates have rebounded since 2020 despite prior declines.

Surgeons must prioritize patient selection and intervention strategies, especially for patients with metabolic liver disease.

• Cholangiocarcinoma incidence is also rising, indicating the need for focused research and management approaches.