Surgical treatment for hepatocellular carcinoma in era of multidisciplinary strategies
International Journal of Clinical Oncology,
Год журнала:
2025,
Номер
unknown
Опубликована: Фев. 5, 2025
Abstract
Hepatocellular
carcinoma
(HCC)
remains
a
significant
global
health
challenge,
with
over
800,000
new
cases
diagnosed
annually.
This
comprehensive
review
examines
current
surgical
approaches
and
emerging
multidisciplinary
strategies
in
HCC
treatment.
While
traditional
criteria,
such
as
the
Barcelona
Clinic
Liver
Cancer
(BCLC)
staging
system,
have
been
relatively
conservative,
recent
evidence
from
high-volume
Asian
centers
supports
more
aggressive
carefully
selected
patients.
The
discusses
evolution
of
selection
including
“Borderline
Resectable
HCC”
classification
which
provides
explicit
guidance
for
decision-making.
Technical
innovations
significantly
enhanced
precision,
three-dimensional
simulation,
intraoperative
navigation
systems,
advancement
minimally
invasive
approaches.
evaluates
ongoing
debate
between
anatomical
versus
non-anatomical
resection
role
robotic
surgery.
In
liver
transplantation,
expanded
criteria
beyond
Milan
show
promising
outcomes,
while
integration
novel
biomarkers
imaging
techniques
improves
patient
selection.
preoperative
adjuvant
therapies
is
increasingly
important,
trials
demonstrating
potential
immune
checkpoint
inhibitors
combined
anti-VEGF
agents
both
settings.
Despite
these
advances,
postoperative
recurrence
challenge.
concludes
that
successful
treatment
requires
personalized
approach,
integrating
expertise
technologies
systemic
considering
individual
factors
regional
variations
practice
patterns.
Язык: Английский
Prognostic factors and clinical significance of preoperative systemic therapy in patients with borderline resectable hepatocellular carcinoma: A JSHBPS project study 2023, Part 2
Journal of Hepato-Biliary-Pancreatic Sciences,
Год журнала:
2025,
Номер
unknown
Опубликована: Март 19, 2025
Abstract
Purpose
To
explore
factors
influencing
the
prognosis
in
patients
with
borderline‐resectable
hepatocellular
carcinoma
(BR‐HCC)
undergoing
surgery.
Methods
The
clinical
data
of
BR‐HCC
according
to
definition
Expert
Consensus
Statement
2023
were
collected
from
board‐certified
HPB
training
centers
and
analyzed
detail.
Results
Data
a
total
1509
(BR1,
n
=
718
BR2,
791)
who
underwent
surgery
collected.
5‐year
disease‐specific
survival
rate
(DSS)
3‐year
recurrence‐free
(RFS)
determined
as
40.8%
19.7%,
respectively.
Multivariate
analysis
identified
oncological
resectability
category
(i.e.,
BR2
vs.
BR1)
significant
prognostic
factor,
also
number
criteria
fulfilled
for
classification
into
disease
being
predictive
DSS
(hazard
ratio
(HR)
[95%
CI]:
one
factor:
1.32
[1.13–1.54];
two
three
factors:
1.51
[1.15–1.96]).
Preceding
systemic
therapy
was
significantly
correlated
longer
(HR,
0.41:
95%
CI,
0.18–0.91)
RFS
0.80:
0.66–0.97)
BR1
disease,
while
its
significance
unclear
disease.
Conclusion
Multicenter
confirm
relevance
potential
advantage
preceding
specific
group
BR‐HCC.
Язык: Английский