Postoperative adjuvant management in hepatocellular carcinoma: A review of therapeutic efficacy and prognostic outcomes.

Primary liver cancer is the sixth most prevalent malignancy worldwide and the third leading cause of cancer-related death. According to the latest data from the National Cancer Center of China, its mortality rate has risen, making it the country's second-deadliest tumor. Hepatocellular carcinoma (HCC), the predominant histological subtype, remains a substantial therapeutic challenge. Hepatectomy is the treatment of choice for HCC; however, because of its insidious onset and aggressive progression, the global 5-year survival rate is only 14.1%, and up to 70% of patients experience recurrence within five years after surgery. Consequently, reducing postoperative recurrence and prolonging survival have become critical research priorities. Currently, no consensus or guidelines exist regarding the clinical efficacy or potential synergistic effects of diagnostic and therapeutic strategies to prevent postoperative recurrence. In recent years, interest has grown in systemic therapies and combined local modalities - particularly targeted agents and immune checkpoint inhibitors, as adjuvant treatments. This review synthesizes recent advances in targeted and immunotherapeutic adjuvant therapies for postoperative HCC to inform clinical practice and improve patient outcomes.