Advances in neoadjuvant therapy for hepatocellular carcinoma

Abstract Hepatocellular carcinoma (HCC) is a common malignant tumor with high morbidity and mortality in China and even in the world. Due to its tumor heterogeneity and susceptibility to distant metastasis, the prognosis of HCC patients tends to be poor, but the traditional interventional treatment options are more limited. Surgical treatment strategies, led by hepatectomy and transplantation, are still the preferred options for the treatment. How to reduce the recurrence rate after surgery has become one of the keys to improve the prognosis. The combination of various local or systemic therapeutic options, such as targeting, immunotherapy, radiotherapy, and intervention, has made great progress in the treatment of unresectable HCC. Systemic therapy represented by targeting and immunotherapy or local treatment options represented by transarterial chemoembolization (TACE) and hepatic artery infusion chemotherapy (HAIC) can be selected according to the individual situation of neoadjuvant therapy. At the same time, issues such as the safety, efficacy and accessibility of neoadjuvant therapy and the selection of subsequent surgery time should also be paid attention to. Therefore, neoadjuvant therapy will become a new hot spot in the treatment of resectable high recurrence risk HCC in the future, which is worth exploring in depth.