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肝细胞癌根治性切除术后辅助治疗的进展与展望

[Progress and perspectives on adjuvant therapy after curative resection of hepatocellular carcinoma].

作者信息

Liang T B

机构信息

Department of Hepatobiliary and Pancreatic Surgery,the First Affiliated Hospital,Zhejiang University School of Medicine;Zhejiang Provincial Key Laboratory of Pancreatic Disease;Zhejiang Provincial Innovation Center for the Study of Pancreatic Disease;Zhejiang Provincial Clinical Research Center for the Study of Hepatobiliary & Pancreatic Diseases;Cancer Center,Zhejiang University,Hangzhou 310003,China.

出版信息

Zhonghua Wai Ke Za Zhi. 2021 Oct 1;59(10):801-806. doi: 10.3760/cma.j.cn112139-20210805-00360.

Abstract

Tumor recurrence after curative resection of hepatocellular carcinoma(HCC) is a major challenge to patient survival. Postoperative adjuvant therapy has been proved to be an effective method in tackling tumor recurrence. However,its role in HCC remains unclear. First,there are many differences between Chinese and foreign guidelines in recommendations on adjuvant therapy of HCC. Chinese guidelines have made many recommendations on various modalities of adjuvant therapy of HCC,including anti-viral therapy,transarterial chemoembolization,and herbs. On the contrary,foreign guidelines don't make any recommendation on adjuvant therapy of HCC,except for anti-viral therapy. Second,clear definition of patients who have a higher risk of tumor recurrence is still unknown. In other words,patients who will benefit from adjuvant therapy is unclear. Although various kinds of adjuvant therapies have been proved to be efficient in preventing tumor recurrence and prolonging patient survival,a standard protocol is still lacking. There are many ongoing clinical trials investigating the value of adjuvant therapy in HCC. Emerging evidences will answer questions on the role of adjuvant therapy and how to perform it.

摘要

肝细胞癌(HCC)根治性切除术后的肿瘤复发是影响患者生存的主要挑战。术后辅助治疗已被证明是应对肿瘤复发的有效方法。然而,其在HCC中的作用仍不明确。首先,中外指南在HCC辅助治疗推荐方面存在诸多差异。中国指南对HCC辅助治疗的各种方式提出了许多建议,包括抗病毒治疗、经动脉化疗栓塞和中药。相反,国外指南除抗病毒治疗外,未对HCC辅助治疗提出任何建议。其次,肿瘤复发风险较高患者的明确定义仍不清楚。换句话说,哪些患者将从辅助治疗中获益尚不清楚。尽管各种辅助治疗已被证明在预防肿瘤复发和延长患者生存期方面有效,但仍缺乏标准方案。目前有许多正在进行的临床试验在研究辅助治疗在HCC中的价值。新出现的证据将回答关于辅助治疗的作用以及如何实施辅助治疗的问题。

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