{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T12:00:43Z","timestamp":1790596843871,"version":"4.1.0"},"reference-count":39,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:p>Hepatocellular carcinoma (HCC) is a heterogeneous tumor\u2013liver\u2013host disease in which treatment selection depends on tumor burden, liver function, portal hypertension, performance status, and patient preferences. Although hepatic resection and other established treatment modalities remain central to curative\u00a0and disease-controlling strategies, emerging biological and digital technologies\u00a0may provide additional information beyond conventional clinical assessment.\u00a0However, their prognostic performance does not necessarily establish clinical\u00a0utility, and many remain insufficiently validated for routine treatment selection.\u00a0This narrative review examines the evolving role of precision-oriented approaches in HCC, including molecular and immune profiling, radiomics, circulating tumor DNA, artificial intelligence, and digital pathology. We classify these approaches into three evidence tiers: established clinical practice, investigational clinical tools, and future hypotheses. We then propose Precision Surgical Oncology as an author-developed, hypothesis-generating framework in which\u00a0guideline-based assessment is followed by biological and host-risk refinement, multidisciplinary interpretation, individualized treatment within established therapeutic pathways, and longitudinal reassessment. Precision Surgical Oncology is intended to complement, rather than replace, evidence-based HCC management. Its future clinical value will depend on prospective validation, reproducibility, defined clinical actionability, equitable implementation, and demonstration of improved patient outcomes.<\/jats:p>","DOI":"10.3389\/fonc.2026.1957598","type":"journal-article","created":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T11:26:41Z","timestamp":1790594801000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Precision surgical oncology for hepatocellular carcinoma"],"prefix":"10.3389","volume":"16","author":[{"given":"Takehiro","family":"Okabayashi","sequence":"first","affiliation":[{"name":"Department of Gastroenterological Surgery, Kochi Health Sciences Center","place":["Kochi, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Motoyasu","family":"Tabuchi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterological Surgery, Kochi Health Sciences Center","place":["Kochi, 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