切换至 "中华医学电子期刊资源库"

中华肝脏外科手术学电子杂志 ›› 2023, Vol. 12 ›› Issue (05) : 486 -489. doi: 10.3877/cma.j.issn.2095-3232.2023.05.003

所属专题: 述评 综述

专家论坛

晚期肝癌综合治疗模式与策略
何传超, 肖治宇()   
  1. 510120 广州,中山大学孙逸仙纪念医院肝胆外科
  • 收稿日期:2023-07-13 出版日期:2023-10-10
  • 通信作者: 肖治宇
  • 基金资助:
    国家自然科学基金面上项目(82172611); 广东省自然科学基金面上项目(2020A1515010232)

Comprehensive treatment mode and strategy for advanced hepatocellular carcinoma

Chuanchao He, Zhiyu Xiao()   

  • Received:2023-07-13 Published:2023-10-10
  • Corresponding author: Zhiyu Xiao
引用本文:

何传超, 肖治宇. 晚期肝癌综合治疗模式与策略[J/OL]. 中华肝脏外科手术学电子杂志, 2023, 12(05): 486-489.

Chuanchao He, Zhiyu Xiao. Comprehensive treatment mode and strategy for advanced hepatocellular carcinoma[J/OL]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2023, 12(05): 486-489.

外科手术切除仍是原发性肝癌(肝癌)最主要的根治性治疗手段,但目前我国肝癌初诊患者可手术切除率仅为30%。初诊适合手术切除的患者术后5年复发率高达40%~70%[1]。较低的初诊可切除率以及较高的术后复发率是制约我国肝癌总体治疗效果的重要原因。在此背景之下,有效提升肝癌可切除率及降低术后复发率成为提升肝癌治疗效果的攻关课题。近年来,围绕上述课题,多种治疗策略、技术手段、系统治疗方案百花齐放,涌现出大批典型案例及突破性临床研究成果,有效方案被录入2022版《原发性肝癌诊疗指南》和《中国临床肿瘤学会原发性肝癌诊疗指南》,改变了肝癌治疗的局面。本文以围绕手术治疗为中心的肝癌综合治疗现状作一论述。

[1]
Wei W, Jian PE, Li SH, et al. Adjuvant transcatheter arterial chemoembolization after curative resection for hepatocellular carcinoma patients with solitary tumor and microvascular invasion: a randomized clinical trial of efficacy and safety[J]. Cancer Commun, 2018, 38(1):61.
[2]
Llovet JM, Ricci S, Mazzaferro V, et al. Sorafenib in advanced hepatocellular carcinoma[J]. N Engl J Med, 2008, 359(4):378-390.
[3]
Zhu K, Chen J, Lai L, et al. Hepatocellular carcinoma with portal vein tumor thrombus: treatment with transarterial chemoembolization combined with sorafenib--a retrospective controlled study[J]. Radiology, 2014, 272(1):284-293.
[4]
Kudo M, Finn RS, Qin S, et al. Lenvatinib versus sorafenib in first-line treatment of patients with unresectable hepatocellular carcinoma: a randomised phase 3 non-inferiority trial[J]. Lancet, 2018, 391(10126):1163-1173.
[5]
Sun HC, Zhu XD. Downstaging conversion therapy in patients with initially unresectable advanced hepatocellular carcinoma: an overview[J]. Front Oncol, 2021(11):772195.
[6]
Machairas N, Tsilimigras DI, Pawlik TM. Current landscape of immune checkpoint inhibitor therapy for hepatocellular carcinoma[J]. Cancers, 2022, 14(8):2018.
[7]
Lyu N, Kong Y, Mu L, et al. Hepatic arterial infusion of oxaliplatin plus fluorouracil/leucovorin vs. sorafenib for advanced hepatocellular carcinoma[J]. J Hepatol, 2018, 69(1):60-69.
[8]
He M, Li Q, Zou R, et al. Sorafenib plus hepatic arterial infusion of oxaliplatin, fluorouracil, and leucovorin vs sorafenib alone for hepatocellular carcinoma with portal vein invasion: a randomized clinical trial[J]. JAMA Oncol, 2019, 5(7):953-960.
[9]
Lyu N, Wang X, Li JB, et al. Arterial chemotherapy of oxaliplatin plus fluorouracil versus sorafenib in advanced hepatocellular carcinoma: a biomolecular exploratory, randomized, phaseⅢ trial (FOHAIC-1)[J]. J Clin Oncol, 2022, 40(5):468-480.
[10]
Galun D, Mijac D, Filipovic A, et al. Precision medicine for hepatocellular carcinoma: clinical perspective[J]. J Pers Med, 2022, 12(2):149.
[11]
Harrington J, Duncan G, DAngelo K, et al. Multidisciplinary simulation improves resident confidence for pregnant patients requiring surgical intervention[J]. Cureus, 2022, 14(3):e23454.
[12]
Egawa H, Esquivel CO, So SK, et al. FK506 conversion therapy in pediatric liver transplantation[J]. Transplantation, 1994, 57(8):1169-1173.
[13]
Sitzmann JV, Abrams R. Improved survival for hepatocellular cancer with combination surgery and multimodality treatment[J]. Ann Surg, 1993, 217(2):149-154.
[14]
Lau WY, Lai EC. Salvage surgery following downstaging of unresectable hepatocellular carcinoma--a strategy to increase resectability[J]. Ann Surg Oncol, 2007, 14(12):3301-3309.
[15]
Li QJ, He MK, Chen HW, et al. Hepatic arterial infusion of oxaliplatin, fluorouracil, and leucovorin versus transarterial chemoembolization for large hepatocellular carcinoma: a randomized phase Ⅲ trial[J]. J Clin Oncol, 2022, 40(2):150-160.
[16]
Cheng AL, Kang YK, Chen Z, et al. Efficacy and safety of sorafenib in patients in the Asia-Pacific region with advanced hepatocellular carcinoma: a phase Ⅲ randomised, double-blind, placebo-controlled trial[J]. Lancet Oncol, 2009, 10(1):25-34.
[17]
Abou-Alfa GK, Meyer T, Cheng AL, et al. Cabozantinib in patients with advanced and progressing hepatocellular carcinoma[J]. N Engl J Med, 2018, 379(1):54-63.
[18]
Qin S, Ren Z, Meng Z, et al. Camrelizumab in patients with previously treated advanced hepatocellular carcinoma: a multicentre, open-label, parallel-group, randomised, phase 2 trial[J]. Lancet Oncol, 2020, 21(4):571-580.
[19]
Sato N, Beppu T, Kinoshita K, et al. Conversion hepatectomy for huge hepatocellular carcinoma with arterioportal shunt after chemoembolization and lenvatinib therapy[J]. Anticancer Res, 2019, 39(10):5695-5701.
[20]
Wakabayashi H, Okada S, Maeba T, et al. Effect of preoperative portal vein embolization on major hepatectomy for advanced-stage hepatocellular carcinomas in injured livers: a preliminary report[J]. Surg Today, 1997, 27(5):403-410.
[21]
Gorgec B, Suhool A, Al-Jarrah R, et al. Surgical technique and clinical results of one- or two-stage laparoscopic right hemihepatectomy after portal vein embolization in patients with initially unresectable colorectal liver metastases: a case series[J]. Int J Surg, 2020(77):69-75.
[22]
Ali A, Ahle M, Bjornsson B, et al. Portal vein embolization with N-butyl cyanoacrylate glue is superior to other materials: a systematic review and meta-analysis[J]. Eur Radiol, 2021, 31(8): 5464-5478.
[23]
D'Haese JG, Neumann J, Weniger M, et al. Should ALPPS be used for liver resection in intermediate-stage HCC?[J]. Ann Surg Oncol, 2016, 23(4):1335-1343.
[24]
Wang Z, Peng Y, Hu J, et al. Associating liver partition and portal vein ligation for staged hepatectomy for unresectable hepatitis B virus-related hepatocellular carcinoma: a single center study of 45 patients[J]. Ann Surg, 2020, 271(3):534-541.
[25]
Li PP, Huang G, Jia NY, et al. Associating liver partition and portal vein ligation for staged hepatectomy versus sequential transarterial chemoembolization and portal vein embolization in staged hepatectomy for HBV-related hepatocellular carcinoma: a randomized comparative study[J]. Hepatobiliary Surg Nutr, 2022, 11(1):38-51.
[26]
Wei X, Jiang Y, Zhang X, et al. Neoadjuvant three-dimensional conformal radiotherapy for resectable hepatocellular carcinoma with portal vein tumor thrombus: a randomized, open-label, multicenter controlled study[J]. J Clin Oncol, 2019, 37(24):2141-2151.
[27]
Zhang Y, Huang G, Wang Y, et al. Is salvage liver resection necessary for initially unresectable hepatocellular carcinoma patients downstaged by transarterial chemoembolization? ten years of experience[J]. Oncologist, 2016, 21(12):1442-1449.
[28]
Wang Z, Ren Z, Chen Y, et al. Adjuvant transarterial chemoembolization for HBV-related hepatocellular carcinoma after resection: a randomized controlled study[J]. Clin Cancer Res, 2018, 24(9):2074-2081.
[29]
Yin J, Li N, Han Y, et al. Effect of antiviral treatment with nucleotide/nucleoside analogs on postoperative prognosis of hepatitis B virus-related hepatocellular carcinoma: a two-stage longitudinal clinical study[J]. J Clin Oncol, 2013, 31(29):3647-3655.
[30]
Huang G, Li PP, Lau WY, et al. Antiviral therapy reduces hepatocellular carcinoma recurrence in patients with low HBV-DNA levels: a randomized controlled trial[J]. Ann Surg, 2018, 268(6):943-954.
[31]
Huang G, Lau WY, Wang ZG, et al. Antiviral therapy improves postoperative survival in patients with hepatocellular carcinoma:a randomized controlled trial[J]. Ann Surg, 2015, 261(1):56-66.
[32]
Zhang W, Zhao G, Wei K, et al. Adjuvant sorafenib reduced mortality and prolonged overall survival and post-recurrence survival in hepatocellular carcinoma patients after curative resection: a single-center experience[J]. Biosci Trends, 2014, 8(6):333-338.
[33]
Zhang XP, Chai ZT, Gao YZ, et al. Postoperative adjuvant sorafenib improves survival outcomes in hepatocellular carcinoma patients with microvascular invasion after R0 liver resection: a propensity score matching analysis[J]. HPB, 2019, 21(12):1687-1696.
[1] 高俊颖, 张海洲, 区泓乐, 孙强. FOLFOX-HAIC 为基础的肝细胞癌辅助转化治疗的应用进展[J/OL]. 中华普通外科学文献(电子版), 2024, 18(06): 457-463.
[2] 李华志, 曹广, 刘殿刚, 张雅静. 不同入路下行肝切除术治疗原发性肝细胞癌的临床对比[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 52-55.
[3] 常小伟, 蔡瑜, 赵志勇, 张伟. 高强度聚焦超声消融术联合肝动脉化疗栓塞术治疗原发性肝细胞癌的效果及安全性分析[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 56-59.
[4] 赖全友, 高远, 汪建林, 屈士斌, 魏丹, 彭伟. 三维重建技术结合腹腔镜精准肝切除术对肝癌患者术后CD4+、CD8+及免疫球蛋白水平的影响[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(06): 651-654.
[5] 屈翔宇, 张懿刚, 李浩令, 邱天, 谈燚. USP24及其共表达肿瘤代谢基因在肝细胞癌中的诊断和预后预测作用[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(06): 659-662.
[6] 陈伟杰, 何小东. 胆囊癌免疫靶向治疗进展[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 763-768.
[7] 公宇, 廖媛, 尚梅. 肝细胞癌TACE术后复发影响因素及预测模型建立[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 818-824.
[8] 李一帆, 朱帝文, 任伟新, 鲍应军, 顾俊鹏, 张海潇, 曹耿飞, 阿斯哈尔·哈斯木, 纪卫政. 血GP73水平在原发性肝癌TACE疗效评价中的作用[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 825-830.
[9] 刘敏思, 李荣, 李媚. 基于GGT与Plt比值的模型在HBV相关肝细胞癌诊断中的作用[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 831-835.
[10] 陆镜明, 韩大为, 任耀星, 黄天笑, 向俊西, 张谞丰, 吕毅, 王傅民. 基于术前影像组学的肝内胆管细胞癌淋巴结转移预测的系统性分析[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 852-858.
[11] 焦振东, 惠鹏, 金上博. 三维可视化结合ICG显像技术在腹腔镜肝切除术治疗复发性肝癌中的应用[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 859-864.
[12] 张龙, 孙善柯, 徐伟, 李文柱, 李俊达, 池涌泉, 何广胜, 成峰, 王学浩, 饶建华. 腹腔镜脾切除治疗血液系统疾病的临床疗效分析[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 870-875.
[13] 陈晓鹏, 王佳妮, 练庆海, 杨九妹. 肝细胞癌VOPP1表达及其与预后的关系[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 876-882.
[14] 王誉英, 刘世伟, 王睿, 曾娅玲, 涂禧慧, 张蒲蓉. 老年乳腺癌新辅助治疗病理完全缓解的预测因素分析[J/OL]. 中华临床医师杂志(电子版), 2024, 18(07): 641-646.
[15] 崔军威, 蔡华丽, 胡艺冰, 胡慧. 亚甲蓝联合金属定位夹及定位钩针标记在乳腺癌辅助化疗后评估腋窝转移淋巴结的临床应用价值探究[J/OL]. 中华临床医师杂志(电子版), 2024, 18(07): 625-632.
阅读次数
全文


摘要


AI


AI小编
你好!我是《中华医学电子期刊资源库》AI小编,有什么可以帮您的吗?