Arterial embolization (AE) and percutaneous thermal ablation (TA) are widely used as local treatments for hepatocellular carcinoma. Arterial embolization includes TACE and TARE, while thermal radiofrequency ablation includes RFA and MWA, both of which work by inducing tumor necrosis. Previously, local treatment prior to transplantation was thought to reduce tumor stage and control tumor progression, but there was no consensus on whether it would benefit patients with hepatocellular carcinoma in the long-term postoperative period. Agopian et al. at the University of California, David Geffen School of Medicine found that local treatment of hepatocellular carcinoma patients in complete remission (cPR) prior to liver transplantation significantly improved long-term survival after transplantation. The study was published in a recent issue of the journal Annals of Surgery. Patients who achieved cPR had recurrence-free survival rates of 92%, 79%, and 73% at 1, 3, and 5 years, respectively (81%, 63%, and 56% in the non-cPR group, respectively), disease-specific survival rates of 100%, 100%, and 99%, respectively (96%, 89%, and 86% in the non-cPR group, respectively), and tumor recurrence rates of 2.4% (15.2% in the incomplete remission group). The tumor recurrence rate was 2.4% (15.2% in the incomplete remission group). The results showed that achieving cPR after receiving local treatment significantly improved long-term survival after liver transplantation. That is, local treatment has a significant benefit for tumor-free survival after transplantation. Specifically, which local treatment regimen maximizes cPR? The investigators concluded that after controlling for other significant predictors of cPR (AFP, cumulative tumor diameter, etc.), the combination of TACE and TA regimens achieved cPR in 35% of patients, which is higher than the odds of cPR with TA alone (29%) and TACE alone (19%). Therefore, the combined treatment regimen is recommended. In conclusion, local treatment of hepatocellular carcinoma patients before liver transplantation can achieve pathologic complete remission, which is a strong predictor of postoperative tumor-free survival. Better local treatment regimens can greatly improve the chance of cPR and thus improve post-transplant outcomes.