Atezolizumab-bevacizumab shows promising long-term survival for patients with unresectable hepatocellular carcinoma.

• Median overall survival is 19.7 months with a 36-month survival rate of 30%.
• 36.8% experienced grade ≥3 adverse events; 14.1% had liver decompensation not related to tumor progression.

Surgeons should consider multidisciplinary approaches, as 14.9% of patients underwent additional surgical or locoregional procedures post-treatment.