Long-term survival rates for hepatocellular carcinoma patients significantly improved following liver resection over 20 years.

• 5-year overall survival rates increased from 68.1% to 90.5% across three time periods (1996-2017).
• Short-term outcomes enhanced, with 90-day mortality dropping to just 0.3% and major complications at 5.0%.

These advancements result from better surgical techniques and patient selection, allowing for safer and more effective surgeries for older patients and those with diverse HCC types.

• Increased identification of non-B and non-C HCC cases and declining cirrhosis rates contribute to this trend.