肝癌全程管理过程中的重要节点评价OA北大核心CSTPCD
Nodal issues of concern for surgeons during the comprehensive treatment of hepatocellular carcinoma
随着医疗技术的不断进步,肝癌的综合治疗手段为病人带来了新的希望.在肝癌综合治疗的全过程中,外科医生需特别关注若干关键节点问题.首先,建立更详细的"潜在转化人群"标准对于筛选适合转化治疗的病人至关重要.通过评估病人肝功能、肿瘤的局限性以及是否存在肝外转移等因素,能够更好地确定哪些病人可能从转化治疗中获益.其次,根据病人的个体差异制定个性化的治疗方案是提高治疗效果的关键.个性化方案应充分考虑病人的整体状况、肿瘤生物学特性以及对靶向治疗和免疫治疗的反应.在转化治疗过程中,对治疗效果和手术安全性的客观评价尤为重要.影像学检查与肿瘤标记物相结合的疗效评估方法有助于准确预测病人的治疗反应和手术预后.然而,这些方法在预测病理反应方面的可靠性仍需进一步验证.在手术节点上,外科医生需特别关注术后肝功能衰竭等并发症的风险,借助三维重建和导航技术能够显著提升手术的安全性.此外,术后辅助治疗的开展对于延长病人无复发生存期至关重要.对于未能成功转化的病人,合理安排后续治疗方案也是改善预后的重要策略.综合治疗为中晚期肝癌病人提供了更多治疗选择和更高的生存机会,但仍需进一步优化治疗策略,以确保病人能够获得最佳的治疗效果和生活质量.全程管理中的这些节点问题是提升肝癌治疗效果的关键,值得外科医生在临床实践中深入研究和关注.
As medical technology continues to advance,comprehensive treatment options for liver cancer are offering new hope to patients.During the whole process of liver cancer management,there are several key issues that surgeons must pay close attention to.Firstly,establishing more detailed criteria for identifying"potential candidates for conversion therapy"is crucial for selecting patients who are likely to benefit from this approach.By assessing patients'liver function,tumor extent,and the presence of extrahepatic metastasis,it is possible to better determine which patients might respond favorably to conversion therapy.Secondly,devising personalized treatment plans based on the individual differences of patients is essential for optimizing therapeutic outcomes.These personalized approaches should consider the patient's overall condition,the biological characteristics of the tumor,and the response to targeted therapy and immunotherapy.During conversion therapy,it is also critical to objectively evaluate treatment effectiveness and surgical safety.Combining imaging studies and tumor biomarkers in efficacy assessment can help predict patient response and surgical prognosis more accurately.However,the reliability of these methods in predicting pathological responses still requires further validation.At the surgical intervention stage,surgeons need to pay particular attention to the risk of postoperative liver failure and other complications.Utilizing 3D reconstruction and navigation technologies can significantly enhance surgical safety.Furthermore,implementing post-operative adjuvant therapy is vital for prolonging patients'recurrence-free survival.For patients who do not successfully undergo conversion therapy,carefully planning subsequent treatment strategies is also crucial for improving outcomes.Comprehensive treatment provides more options and better survival prospects for patients with advanced liver cancer,but further optimization of treatment strategies is needed to ensure that patients achieve the best possible therapeutic outcomes and quality of life.These key issues in the management process are critical for improving liver cancer treatment efficacy and warrant in-depth investigation and attention from surgeons in clinical practice.
陈亚进;张磊
中山大学孙逸仙纪念医院肝胆外科,广东广州 510120
临床医学
肝细胞癌综合治疗转化治疗新辅助治疗
hepatocellular carcinomacomprehensive treatmentconversion therapyneoadjuvant therapy
《中国实用外科杂志》 2024 (009)
996-1001 / 6
广东省自然科学基金面上项目(No.2024A1515010139)
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