中国实用外科杂志2024，Vol.44Issue(9)：1010-1015,6.DOI:10.19538/j.cjps.issn1005-2208.2024.09.09
综合治疗时代肝癌外科手术治疗地位与时机变迁
The evolution of the role and timing of surgical treatment in liver cancer in the era of comprehensive therapy
摘要
Abstract
In the era of comprehensive treatment,the therapeutic strategy for hepatocellular carcinoma(HCC)has gradually evolved,leading to changes in the role and timing of surgical intervention.Surgical treatments for liver cancer,especially liver resection and liver transplantation,remain fundamental approaches for achieving long-term survival outcomes in patients with HCC.However,with the advent of targeted therapies and immunotherapies,combined with locoregional treatments,the comprehensive treatment framework for HCC has been refined,resulting in adjustments to the indications and timing for surgical procedures.Conversion therapy,which utilizes locoregional or systemic treatment to downstage tumors that were initially unresectable or unsuitable for surgery,has shown favorable long-term survival outcomes.Evidence suggests that patients who undergo subsequent surgical resection after successful conversion therapy exhibit superior overall survival(OS)compared to those who continue with locoregional or systemic therapies.Moreover,even in cases where radiological complete response(rCR)or clinical complete response(cCR)is achieved,surgical treatments still offer potential benefits.Therefore,evaluating tumor response after successful conversion therapy and performing timely surgical resection is crucial for optimizing treatment outcomes in HCC.Additionally,the optimal duration of postoperative adjuvant therapy and the precise timing of surgery remain areas that require further research and robust evidence.The advancement of comprehensive treatment,particularly through the implementation of neoadjuvant and adjuvant therapeutic strategies,has increased the complexity and diversity of HCC management,posing new challenges and opportunities for the role of surgical intervention in liver cancer.关键词
肝细胞癌/外科手术/综合治疗/转化治疗/新辅助治疗/免疫治疗/靶向治疗/肝癌预后Key words
hepatocellular carcinoma/surgical treatment/comprehensive treatment/conversion therapy/neoadjuvant therapy/immunotherapy/targeted therapy/prognosis分类
医药卫生引用本文复制引用
杨宁,沈锋..综合治疗时代肝癌外科手术治疗地位与时机变迁[J].中国实用外科杂志,2024,44(9):1010-1015,6.基金项目
上海市卫健委临床重点专科项目(No.shslczdzk02402) （No.shslczdzk02402）
军队临床重点专科建设项目 （）
上海市申康医院发展中心示范性研究型病房建设项目(No.SHDC2023CRW002) （No.SHDC2023CRW002）
上海市申康医院发展中心肝癌专病队列数据质量提升项目(No.SHDC2024CRX023) （No.SHDC2024CRX023）
