肝细胞癌（肝癌）是全球范围内致死率较高的恶性肿瘤之一，中国患者群体占比尤为显著。尽管早期可通过手术实现根治性治疗，但术后复发问题严重制约患者长期生存。近年来，围手术期综合治疗策略成为研究热点，其核心在于通过多科学协作，采用术前新辅助治疗与术后辅助治疗降低患者术后复发风险并改善预后。术前新辅助治疗通过局部与系统治疗的协同作用缩小肿瘤体积，为手术创造更优条件。传统介入手段如TACE技术通过阻断肿瘤血供实现局部控制，而肝动脉灌注化疗因药物浓度的优化分布展现出更高疗效。术后辅助治疗主要针对存在高危复发因素的患者（如微血管侵犯）。靶向与免疫联合治疗方案在部分研究中显示出延长疾病控制周期和激活免疫应答的潜力，但需注意治疗过程中可能出现的肿瘤进展，以及药物不良反应对手术的影响。靶向联合免疫治疗的探索逐渐成为主流，临床证据表明其可能延缓复发时间，但对复发率的长期影响仍需进一步验证。未来需结合分子标志物（如循环肿瘤特征或免疫微环境指标）实现精准患者分层，并优化治疗周期以平衡疗效与安全性，推动“局部-系统-免疫”全周期管理模式的建立。

Hepatocellular carcinoma (HCC) is one of the malignant tumors with high mortality worldwide, especially in China. Although radical resection can be achieved in the early stage, postoperative recurrence seriously limits the long-term survival of HCC patients. In recent years, perioperative comprehensive treatment strategy has become a research hotspot, the core of which is to reduce the risk of postoperative recurrence and improve clinical prognosis through multidisciplinary team (MDT) cooperation by using preoperative neoadjuvant therapy and postoperative adjuvant therapy. Preoperative neoadjuvant therapy can shrink the tumor volume through the synergistic effect of local and systemic therapy, creating favorable conditions for surgery. Traditional interventional methods, such as TACE, can achieve local control by blocking tumor blood supply, while hepatic arterial infusion chemotherapy exhibits higher efficacy due to the optimal distribution of drug concentration. Postoperative adjuvant therapy mainly targets patients with high-risk factors for recurrence (such as microvascular invasion). Some studies have shown that the combination of targeted and immune therapy shows the potential to prolong the cycle of disease control and activate the immune response, whereas special attention should be paid to the risk of tumor progression during the treatment and the influence of adverse drug reactions on surgical resection. Targeted immunotherapy has gradually become the mainstream option. Clinical evidence shows that it may delay the recurrence time, but the long-term impact on recurrence rate remains to be investigated. Subsequently, it is necessary to combine with molecular markers (such as circulating tumor characteristics or immune microenvironment indexes) to achieve precise patient stratification, optimize the treatment cycle to balance efficacy and safety, and promote the establishment of a 'local-systemic-immune' full-cycle management mode.