The Evolving Role of Surgery in Hepatocellular Carcinoma Management: From Resection to Multidisciplinary Strategy

BACKGROUND: Hepatocellular carcinoma (HCC) frequently develops in the setting of chronic liver disease, making its management uniquely complex and historically centered on surgery. RECENT FINDINGS: Advances in locoregional therapies, molecular targeted agents, and immune checkpoint inhibitors have profoundly transformed treatment algorithms. Immunotherapy-based combinations achieve deep and durable responses, enabling downstaging, conversion surgery, and perioperative strategies previously considered unfeasible. CONCLUSION: In the contemporary era, surgeons serve not only as technical operators but as strategic leaders within multidisciplinary teams, integrating evolving systemic and local therapies to achieve durable oncologic outcomes.