Adjuvant therapies significantly reduce recurrence risk in hepatocellular carcinoma patients after hepatectomy.

• Radiotherapy (RT) shows the best results for disease-free survival (HR 0.31) and overall survival (HR 0.31).
• Tyrosine kinase inhibitors (TKI) also improve outcomes but are less effective than RT (HR 0.48 for DFS, HR 0.50 for OS).

Surgeons should consider RT as the primary adjuvant therapy for high-risk patients to enhance postoperative outcomes.

• A total of 45 studies with 8,409 patients were analyzed, confirming the efficacy of RT, TKI, transarterial chemoembolization (TACE), and hepatic arterial infusion of FOLFOX.