手术仍然是肝细胞癌（HCC）治疗的主要手段。然而，手术治疗效果受到术后复发的显著影响，超过一半的病例由于肝内转移或新发肿瘤而引起复发。几十年来，抑制术后HCC复发的大多数治疗策略都集中在残留肿瘤细胞上，但临床上很少观察到满意的治疗效果。近年来，对肿瘤生物学的更好理解使我们将重点从肿瘤细胞转向术后肿瘤微环境（TME），后者被逐渐认识为在肿瘤复发中发挥关键作用。在本综述中，我们描述了各种对术后TME施加的手术应激和干扰。此外，我们还讨论了这些TME中的变化如何导致HCC术后复发。基于其临床意义，我们还强调了术后TME作为术后辅助治疗的潜在靶点。© 2023 The Authors. Medicinal Research Reviews published by Wiley Periodicals LLC.

Surgery remains to be the mainstay of treatment for hepatocellular carcinoma (HCC). Nonetheless, its therapeutic efficacy is significantly impaired by postoperative recurrence, which occurs in more than half of cases as a result of intrahepatic metastasis or de novo tumorigenesis. For decades, most therapeutic strategies on inhibiting postoperative HCC recurrence have been focused on the residual tumor cells but satisfying therapeutic outcomes are barely observed in the clinic. In recent years, a better understanding of tumor biology allows us to shift our focus from tumor cells toward the postoperative tumor microenvironment (TME), which is gradually identified to play a pivotal role in tumor recurrence. In this review, we describe various surgical stress and surgical perturbation on postoperative TME. Besides, we discuss how such alternations in TME give rise to postoperative recurrence of HCC. Based on its clinical significance, we additionally highlight the potential of the postoperative TME as a target for postoperative adjuvant therapeutics.© 2023 The Authors. Medicinal Research Reviews published by Wiley Periodicals LLC.