靶向免疫治疗时代的肝癌肝切除术再思考

doi:10.3877/cma.j.issn.2095-3232.2024.01.003

外科手术一直以来都被认为是治愈肝细胞癌的最有效手段，即使经过近百年的发展，外科为患者带来的生存获益似乎并未进一步提高。近些年，靶向药物及免疫检查点抑制剂的广泛应用为肝癌的综合治疗和相关研究提供了新的发展方向。随着临床应用越来越多，靶免治疗在各阶段肝癌治疗中的优势也不断体现，这也让我们不得不重新思考原有的肝癌外科治疗理念是否仍然正确。在此我们深入讨论在靶免时代，肝癌肝切除术所面临的问题及可能的解决方案。

关键词: 癌，肝细胞, 靶向治疗, 免疫治疗, 肝切除术, 程序性死亡受体1（PD-1）, 微小残留病灶（MRD）

Surgery has been considered as the most effective treatment for hepatocellular carcinoma (HCC). In spite of almost 100-year development, the survival benefits brought by surgery for HCC patients have not been further improved. In recent years, widespread application of targeted drugs and immune checkpoint inhibitors have provided a novel development direction for comprehensive treatment and related research of HCC. With widespread clinical application, the advantages of targeted immune therapy in the treatment of HCC at all stages are constantly presented, which make surgeons rethink whether the original concept of surgery for HCC is still correct. In this article, the problems and potential solutions in hepatectomy for HCC in the era of targeted immunotherapy were in-depth discussed.

Key words: Carcinoma, hepatocellular, Target therapy, Immuno-therapy, Hepatectomy, Programmed death-1 (PD-1), Minimal residual disease (MRD)

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Rethink of hepatectomy for hepatocellular carcinoma in the era of targeted immunotherapy

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Rethink of hepatectomy for hepatocellular carcinoma in the era of targeted immunotherapy