NIVO+IPI Neoadjuvant Therapy for Recurrent Resectable HCC

This study will evaluate nivolumab and ipilimumab, two immunotherapy medicines, given before repeat liver surgery in adults whose liver cancer (hepatocellular carcinoma) has returned within the liver after previous surgery. Participants are planned to receive both medicines by intravenous infusion once every 3 weeks for 2 cycles, followed by surgery if they remain suitable. Researchers will examine the removed tumor tissue to assess treatment response. Treatment side effects and surgical outcomes will also be evaluated.

Inclusion Criteria: 1. The subject or their legally authorized representative must sign a written informed consent form (ICF) approved by the IRB/IEC, with the date indicated, prior to undergoing any study-related procedures. 2. Subjects must be willing and able to comply with the scheduled visits, treatment regimen, laboratory assessments, and other study requirements. 3. Male and female subjects aged \>= 18 and \= 3 months. 5. Subjects must have histologically, cytologically, or clinically confirmed HCC. 6. Subjects should, as much as possible, provide tumor tissue specimens from the initial surgical resection of HCC (1 formalin-fixed paraffin-embedded \[FFPE\] tissue block or 20 unstained tumor tissue slides) during the screening period. 7. Subjects must have intrahepatic recurrence confirmed by imaging (contrast-enhanced CT or MRI) occurring 3 months to 2 years after initial liver resection. 8. Subjects must be assessed by the investigator as eligible for repeat hepatic resection, in accordance with the Chinese Expert Consensus on Prevention and Treatment of Postoperative Recurrence of Hepatocellular Carcinoma (2020 edition): * Subjects in generally good condition. * Liver function Child-Pugh class A, with none or only mild portal hypertension. * No severe underlying diseases of major organs such as heart, lung, or kidney. * Lesion(s) are either solitary or multiple (\= 15 mm. * The lesion must not have been previously treated with surgery, radiotherapy, and/or local regional therapy (e.g., RFA, PEI or PAI, cryoablation, HIFU, TACE, TAE, etc.). 10. Eastern Cooperative Oncology Group Performance Status (ECOG PS) of 0. 11. Subjects must not have received prior systemic immune checkpoint inhibitor therapy. 12. Subjects must have adequate organ and bone marrow function. Screening laboratory values must meet the following criteria and must be obtained within 7 days prior to enrollment (administration of any blood products, growth factors, albumin, or other corrective treatments is not permitted within 14 days prior to obtaining the laboratory assessments): * Adequate hematologic function: * Absolute neutrophil count (ANC) \>= 1.5 x 10\^9/L * Platelet count (PLT) \>= 75 x 10\^9/L * Hemoglobin (HGB) \>= 9.0 g/dL * Adequate hepatic function: * Serum total bilirubin (TBIL) \ 150 mmHg or diastolic blood pressure \> 90 mmHg. * History of congestive heart failure greater than New York Heart Association (NYHA) class II. * Active coronary artery disease, unstable or newly diagnosed angina, or myocardial infarction within 6 months prior to screening. * Arrhythmias requiring antiarrhythmic therapy other than beta-blockers or digoxin at screening. * Cardiac valvular disease graded \> Grade 2 according to CTCAE. * QTc interval (Fridericia formula) \> 480 ms on 2 consecutive ECGs. 15. Symptomatic or potentially interfering interstitial lung disease that may affect the detection or management of drug-related pulmonary toxicity. 16. History of gastrointestinal or non-gastrointestinal fistula or gastrointestinal perforation. 17. History of non-healing wounds or skin ulcers within 3 months prior to enrollment. 18. History of thrombotic or embolic events (excluding HCC tumor thrombus) within 6 months prior to enrollment, such as cerebrovascular accidents (including transient ischemic attacks) or pulmonary embolism. 19. History of any CTCAE Grade \>= 3 hemorrhagic events within 8 weeks prior to enrollment, or currently receiving thrombolytic therapy. 20. Systemic treatment with corticosteroids (\> 10 mg/day prednisone or equivalent) or other immunosuppressive agents within 14 days prior to study drug administration. 21. Immunological contraindications or concurrent severe autoimmune diseases where the investigator considers immune checkpoint inhibitor therapy to carry excessive risk, including but not limited to: * Active severe autoimmune diseases (e.g., systemic lupus erythematosus, Sjogren's syndrome, myasthenia gravis, ulcerative colitis, Crohn's disease, refractory psoriasis, etc.) requiring medium- to high-dose immunosuppressive therapy for maintenance. * Confirmed severe combined immunodeficiency, acquired immunodeficiency syndrome (AIDS), or immunodeficiency states such as critically low CD4+ T-cell counts. * Recent (e.g., \ 10 mg/day prednisone equivalent) or other drugs affecting immune function (short-term use for irAE management or perioperative period is not included). * Requirement for ongoing immunosuppressive therapy due to organ transplantation. * Investigator's assessment based on medical history or current condition indicates other high-risk immunologic abnormalities that make the subject unsuitable for immune checkpoint inhibitor therapy. 22. Known hypersensitivity to Nivolumab, Ipilimumab, any of their excipients, or history of severe hypersensitivity reactions to other monoclonal antibodies. 23. Presence of concomitant malignancy requiring treatment (at screening) or history of active prior malignancy within 2 years prior to enrollment. Note: Subjects with a history of prior malignancy are eligible if treatment was completed \>= 2 years ago and there is no evidence of disease. Additionally, subjects with a history of prior early-stage basal/squamous cell skin cancer or non-invasive/in situ carcinoma are eligible if they received targeted therapy at any time. 24. Any serious or uncontrolled medical condition that, in the investigator's opinion, may increase the risk of participation, compromise the subject's ability to receive study treatment, or interfere with the interpretation of study results. 25. History of major surgical procedures, open biopsies, or significant trauma within 4 weeks prior to enrollment, or minor surgical procedures (e.g., core needle biopsy) within 1 week prior to enrollment. 26. Subjects with a history of life-threatening toxicities related to prior systemic anticancer therapy, except for those unlikely to recur after standard-of-care management. 27. Pregnant or breastfeeding women of childbearing potential (WOCBP).