Surgeons need to adapt to evolving strategies for hepatocellular carcinoma (HCC) that prioritize biological insights and dynamic eligibility criteria.

• Curative treatments offer optimal long-term outcomes, yet 5-year recurrence rates remain at about 70%.
• New methods in immunogenomic profiling and liquid biopsy enhance patient selection beyond traditional staging.

These advances enable personalized surgical strategies and improve outcomes.

• Innovations in perioperative immunotherapy and graft preservation techniques may further reduce recurrence risk and broaden curative options.