Expert consensus on pathological evaluation of efficacy after neoadjuvant and conversion therapy for hepatocellular carcinoma (2025 edition)

Establishing the optimal surgical time for hepatocellular carcinoma, optimizing neoadjuvant and conversion therapy (NCT) strategies are hot topics in clinical research, and reducing post-operative recurrence and metastasis rates. Pathology evaluation can intuitively and accurately assess the efficacy of NCT. However, current research on pathological response to NCT for HCC is still incomplete, and there is no unified standard for evaluating post‑treatment pathological response and pathological remission. The Pathology Group of Liver Cancer Professional Committee of the Chinese Anti‑Cancer Association and Liver Cancer Group of Oncology Pathology Professional Committee of the Chinese Anti‑Cancer Association organize multidisciplinary experts to synthesize the latest domestic and foreign research, combined with domestic and foreign clinical treatment guidelines as well as clinical data and practical experience in China, formulate the Expert Consensus on Pathological Evaluation of Efficacy after Neoadjuvant and Conversion Therapy for Hepatocellular Carcinoma (2025 Edition). This consensus aims to standardize clinical information collection, gross sampling, microscopic evaluation, and the protocol of pathological reports diagnosis, and puts forward 10 basic consen-suses. It is expected to improve the consistency of pathological evaluation, promote the use of major pathological response cut‑off values after NCT for HCC as surrogate endpoints for the evaluation of survival benefits in clinical trials, and provide a basis for clinical selection of further treatment plans and prognosis.