Nault Jean-Charles, Calderaro Julien, Ronot Maxime
Liver unit, Hôpital Avicenne, Hôpitaux Universitaires Paris-Seine-Saint-Denis, Assistance-Publique Hôpitaux de Paris, Bobigny, France; Unité de Formation et de Recherche Santé Médecine et Biologie Humaine, Université Paris 13, Communauté d'Universités et Etablissements Sorbonne Paris Cité, Paris, France; Centre de Recherche des Cordeliers, Sorbonne Université, Inserm, Université de Paris, team « Functional Genomics of Solid Tumors », F-75006 Paris, France.
Université Paris Est Créteil, INSERM, IMRB, F-94010, Créteil, France; Assistance Publique-Hôpitaux de Paris, Henri Mondor-Albert Chenevier University Hospital, Department of Pathology, Créteil, France; MINT-Hep, Mondor Integrative Hepatology, Créteil, France.
J Hepatol. 2024 Oct;81(4):756-762. doi: 10.1016/j.jhep.2024.05.041. Epub 2024 Jun 11.
Primary liver tumours, including benign liver tumours, hepatocellular carcinoma and cholangiocarcinoma, present a multifaceted challenge, necessitating a collaborative approach, as evidenced by the role of the multidisciplinary tumour board (MDTB). The approach to managing primary liver tumours involves specialised teams, including surgeons, radiologists, oncologists, pathologists, hepatologists, and radiation oncologists, coming together to propose individualised treatment plans. The evolving landscape of primary liver cancer treatment introduces complexities, particularly with the expanding array of systemic and locoregional therapies, alongside the potential integration of molecular biology and artificial intelligence (AI) into MDTBs in the future. Precision medicine demands collaboration across disciplines, challenging traditional frameworks. In the next decade, we anticipate the convergence of AI, molecular biology, pathology, and advanced imaging, requiring adaptability in MDTB structure to incorporate these cutting-edge technologies. Navigating this evolution also requires a focus on enhancing basic, translational, and clinical research, as well as boosting clinical trials through an upgraded use of MDTBs as hubs for scientific collaboration and raising literacy about AI and new technologies. In this review, we will delineate the current unmet needs in the clinical management of primary liver cancers, discuss our perspective on the future role of MDTBs in primary liver cancers ("next generation" MDTBs), and unravel the potential power and limitations of novel technologies that may shape the multidisciplinary care landscape for primary liver cancers in the coming decade.
原发性肝脏肿瘤，包括良性肝脏肿瘤、肝细胞癌和胆管癌，带来了多方面的挑战，需要采取协作方法，多学科肿瘤委员会（MDTB）所发挥的作用就证明了这一点。原发性肝脏肿瘤的管理方法涉及专业团队，包括外科医生、放射科医生、肿瘤内科医生、病理科医生、肝病专家和放射肿瘤学家，他们共同提出个体化的治疗方案。原发性肝癌治疗的不断发展带来了复杂性，特别是随着全身和局部区域治疗方法的不断增加，以及未来分子生物学和人工智能（AI）可能整合到多学科肿瘤委员会中。精准医学需要跨学科合作，这对传统框架提出了挑战。在未来十年，我们预计人工智能、分子生物学、病理学和先进成像技术将融合，这就要求多学科肿瘤委员会的结构具有适应性，以纳入这些前沿技术。应对这一演变还需要注重加强基础研究、转化研究和临床研究，并通过将多学科肿瘤委员会升级为科学合作中心以及提高对人工智能和新技术的认知水平来推动临床试验。在本综述中，我们将阐述原发性肝癌临床管理中目前未满足的需求，讨论我们对多学科肿瘤委员会在原发性肝癌中未来作用（“下一代”多学科肿瘤委员会）的看法，并揭示可能在未来十年塑造原发性肝癌多学科护理格局的新技术的潜在力量和局限性。
