A panel of experts reached consensus on guidelines for clinical trials evaluating systemic therapies in hepatocellular carcinoma (HCC) patients undergoing surgical or locoregional treatment, emphasizing patient selection and outcome measures.

• Nine consensus statements were established for both neoadjuvant and combination therapy trials, focusing on high-risk patients and clinically relevant endpoints.
• For neoadjuvant therapy, the primary outcome should be 2-year event-free survival; for combination therapy, use progression-free survival and overall survival.

These guidelines could influence trial designs, ensuring rigorous evaluation of systemic therapies in surgical HCC management.