PROBLEM IDENTIFICATION: Postoperative comfort management for patients with hepatocellular carcinoma undergoing hepatic arterial infusion chemotherapy remains unstandardized, with fragmented evidence limiting clinical practice. LITERATURE SEARCH: To establish China's first evidence-based framework for postoperative physiologic comfort management in patients with hepatocellular carcinoma undergoing hepatic arterial infusion chemotherapy, a systematic evidence synthesis, guided by the 6S Pyramid, was conducted. Sixteen databases, including PubMed®, Cochrane Library, and CNKI, were searched from inception to July 2024. DATA EVALUATION: Literature was systematically retrieved, appraised, and synthesized. Two researchers independently assessed study quality using AGREE II (Appraisal of Guidelines for Research and Evaluation) and JBI tools. Evidence extraction followed hierarchical principles, with conflicts resolved through panel arbitration. SYNTHESIS: 14 studies were included, yielding 13 recommendations across the following six domains: patient education, nausea and vomiting control, gastrointestinal recovery, pain management, urinary retention, and early mobilization. IMPLICATIONS FOR PRACTICE: The proposed postoperative physiologic comfort management framework enables standardized nursing protocols across hospital settings, prioritizes patient-centered outcomes, and establishes measurable comfort metrics. Nurses can implement structured preoperative education and functional training while adopting stratified symptom management for patients undergoing hepatic arterial infusion chemotherapy.