[New concepts in perioperative refined management of liver resection for hepatocellular carcinoma].

Abstract

Liver resection for hepatocellular carcinoma (HCC) still faces the dual challenges of operative safety and high postoperative recurrence. Traditional precision surgery mainly focuses on operative manipulation, whereas the concept of scientific hepatectomy incorporates cirrhosis background, tumor biological behavior, and coordination with systemic therapy into a unified decision-making framework. This article discusses perioperative refined management strategies guided by scientific hepatectomy. Preoperatively, the severity of cirrhosis should be evaluated to define the safe extent of resection. Intraoperatively, oncological radicality should be balanced against liver parenchymal preservation. During the perioperative period, neoadjuvant therapy, conversion therapy, and adjuvant therapy should be integrated to promote the transition of HCC surgery toward comprehensive treatment. The focus of scientific hepatectomy is not merely to improve operative precision, but to select a more appropriate resection timing, resection extent, and treatment coordination strategy according to cirrhosis severity, tumor biological risk, and the need for subsequent treatment.