Perioperative immunotherapy and immune surveillance in hepatocellular carcinoma

Hepatocellular carcinoma (HCC) continues to carry a substantial risk of recurrence after potentially curative liver resection. The perioperative period represents a biologically active but insufficiently understood window in which surgical stress, ischemia–reperfusion injury, tissue repair, systemic inflammation, and transient immunosuppression can reshape systemic and intratumoral immunity. These changes may influence residual tumor cell survival, immune escape, and metastatic outgrowth. At the same time, immune checkpoint inhibitors, anti-angiogenic agents, locoregional treatments, and other immunomodulatory approaches are increasingly being investigated before or after surgery. Neoadjuvant studies are particularly valuable because paired specimens can reveal treatment-associated changes in the tumor microenvironment. Defining how perioperative interventions regulate antitumor immunity and therapeutic resistance is therefore essential for developing more precise strategies to prevent recurrence.This Research Topic aims to clarify the immune mechanisms that determine response, resistance, and recurrence during perioperative treatment of HCC. Key questions include how surgery and neoadjuvant or adjuvant therapies alter immune surveillance; which patients are most likely to benefit from perioperative immunotherapy; how treatment timing and combinations influence immune remodeling; and which biomarkers can identify pathological response, minimal residual disease, or emerging resistance. Recent advances in immune checkpoint blockade, anti-angiogenic combinations, locoregional–systemic treatment, circulating tumor DNA, single-cell and spatial profiling, multiplex imaging, and computational pathology provide new opportunities to address these questions. We particularly encourage studies integrating mechanistic analyses of tumor tissue, adjacent non-tumorous liver, peripheral blood, and tumor-draining lymph nodes with treatment response and recurrence-related outcomes. The overarching goal is to support biologically informed, biomarker-guided perioperative strategies that improve tumor control while maintaining surgical safety. This Research Topic will focus on immune mechanisms and immunotherapy associated with curative-intent surgical treatment of HCC, including neoadjuvant, adjuvant, and immediate perioperative settings. Contributions centered exclusively on retrospective clinical outcomes without immunological or translational insight are outside the primary scope. We welcome articles addressing, but not limited to, the following themes:• Perioperative immune activation, immunosuppression, inflammation, and immune escape;• Effects of surgical stress and ischemia–reperfusion injury on antitumor immunity;• Neoadjuvant, adjuvant, and perioperative immune checkpoint blockade;• Combination strategies involving anti-angiogenic or targeted therapies, radiotherapy, ablation, TACE, or HAIC;• Immune correlates of pathological response and minimal residual disease;• Circulating tumor DNA and other biomarkers of response, recurrence, and resistance;• Tumor immune microenvironment profiling using single-cell sequencing, spatial transcriptomics, multiplex imaging, or computational pathology;• Immune-related adverse events, treatment timing, hepatic function, wound healing, and surgical safety;Translational models of immune surveillance, postoperative recurrence, and immunotherapy resistance.Please note: Manuscripts consisting solely of bioinformatics or computational analysis of public genomic or transcriptomic databases which are not accompanied by validation (independent cohort or biological validation in vitro or in vivo) are out of scope for this section and will not be accepted as part of this Research Topic.Please note that Dr. Ghassan K. Abou-Alfa has received research support from AbbVie, Agenus, Amgen, Arcus, AstraZeneca, Atara, BeiGene, BioNTech, BMS, Coherus, Digestive Care, Elicio, Genentech/Roche, Helsinn, Incyte, J-Pharma, Revolution Medicines, Tango Therapeutics, and Yiviva, and has received consulting support from AbbVie, AbilityPharma, Agenus, Alligator Biosciences, Amgen, Astellas, Arcus, AstraZeneca, Autem, Berry Genomics, BioNTech, BMS, Boehringer Ingelheim, FibroGen, Genentech/Roche, Ikena, Immuneering, Ipsen, J-Pharma, Merck, Merus, Moma Therapeutics, Neogene, Novartis, Pfizer, Regeneron, Revolution Medicines, Servier, Syros, Tango Therapeutics, Tempus, Vector, and Yiviva. Topic editors: GHASSAN ABOU-ALFA, Yang Ke, Lei Huang Source: https://www.frontiersin.org/research-topics/85631/perioperative-immunotherapy-and-immune-surveillance-in-hepatocellular-carcinoma