Jeng Wen-Juei, Lin Chen-Chun, Chen Wei-Ting, Sheen I-Shyan, Lin Chun-Yen, Lin Shi-Ming
Division of Hepatology, Liver Research Unit, Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital and Chang Gung University, College of Medicine, Taipei, Taiwan, ROC.
Dig Dis. 2014;32(6):747-54. doi: 10.1159/000368017. Epub 2014 Oct 29.
Hepatocellular carcinoma (HCC) is a common malignancy in the world. Although resection and various locoregional therapies can achieve eradication or complete ablation of small HCC, HCC recurrence after these therapies is still common. Although candidates for medical ablation usually exhibit compensated hepatic functional status, the frequent recurrence of HCC after successful ablation contributes to short survival. Therefore, attempts to prevent HCC recurrence are essential to prolong survival. Efforts in preventing HCC recurrence after curative therapies include prevention of early recurrence by improving liver immunity and eliminating microscopic tumor foci or micrometastases, and prevention of late recurrence by reducing the hepatitis activity and using antiviral therapies based on viral suppression/eradication. In HCC with vascular invasion, adjuvant transcatheter arterial chemoembolization should be considered to provide better control. Whether the adjuvant use of sorafenib may suppress microscopic tumor foci or micrometastases may be unveiled in the near future. This review article will update the algorithms, novel medication or study drugs in the prevention of HCC after curative therapies.
肝细胞癌（HCC）是全球常见的恶性肿瘤。尽管手术切除和各种局部区域治疗能够实现小肝癌的根除或完全消融，但这些治疗后肝癌复发仍很常见。虽然适合进行药物消融的患者通常肝功能处于代偿状态，但成功消融后肝癌的频繁复发导致生存期较短。因此，预防肝癌复发对于延长生存期至关重要。在根治性治疗后预防肝癌复发的努力包括通过改善肝脏免疫力和消除微小肿瘤病灶或微转移来预防早期复发，以及通过降低肝炎活动度和基于病毒抑制/根除使用抗病毒疗法来预防晚期复发。对于有血管侵犯的肝癌，应考虑辅助经动脉化疗栓塞以更好地控制病情。索拉非尼辅助使用是否能抑制微小肿瘤病灶或微转移可能在不久的将来得以揭示。这篇综述文章将更新根治性治疗后预防肝癌的算法、新型药物或研究性药物。
