Primary liver cancer, particularly hepatocellular carcinoma, is one of the most common malignancies in China, and hepatectomy remains the primary curative treatment. However, the efficacy of hepatectomy is significantly limited due to the heterogeneity of liver cancer, its high recurrence rate, and the fact that most patients are diagnosed at advanced stages. In recent years, the development of precision medicine has brought new hope to liver cancer treatment, especially with notable advancements in preoperative assessment, systemic therapy, minimally invasive surgery, and personalized treatment strategies. Preoperative assessment, including imaging technologies such as three-dimensional visualization and molecular imaging, helps physicians accurately evaluate tumor characteristics and liver function, guiding the choice of treatment plan. The combined application of immunotherapy and targeted therapy has significantly improved survival rates for patients with advanced liver cancer. The strategy of combining systemic therapy with local treatment has provided new pathways for translational therapy, expanding the indications for hepatectomy. The optimal selection of patients based on tumor biological characteristics, especially molecular subtyping and liver function status, to maximize patient benefit still requires further exploration. The "seven-step" modular laparoscopic hepatectomy, by achieving scientific hepatectomy, demonstrates the clinical practice of maximizing patient benefit, further elucidating a multidisciplinary, personalized treatment model centered on surgical therapy.