The evolution of the role and timing of surgical treatment in liver cancer in the era of comprehensive therapy
YANG Ning
SHEN Feng
Abstract：In the era of comprehensive treatment,the therapeutic strategy for hepatocellular carcinoma(HCC)has gradually evolved,leading to changes in the role and timing of surgical intervention.Surgical treatments for liver cancer,especially liver resection and liver transplantation,remain fundamental approaches for achieving long-term survival outcomes in patients with HCC.However,with the advent of targeted therapies and immunotherapies,combined with locoregional treatments,the comprehensive treatment framework for HCC has been refined,resulting in adjustments to the indications and timing for surgical procedures.Conversion therapy,which utilizes locoregional or systemic treatment to downstage tumors that were initially unresectable or unsuitable for surgery,has shown favorable long-term survival outcomes.Evidence suggests that patients who undergo subsequent surgical resection after successful conversion therapy exhibit superior overall survival(OS)compared to those who continue with locoregional or systemic therapies.Moreover,even in cases where radiological complete response(rCR)or clinical complete response(cCR)is achieved,surgical treatments still offer potential benefits.Therefore,evaluating tumor response after successful conversion therapy and performing timely surgical resection is crucial for optimizing treatment outcomes in HCC.Additionally,the optimal duration of postoperative adjuvant therapy and the precise timing of surgery remain areas that require further research and robust evidence.The advancement of comprehensive treatment,particularly through the implementation of neoadjuvant and adjuvant therapeutic strategies,has increased the complexity and diversity of HCC management,posing new challenges and opportunities for the role of surgical intervention in liver cancer.
Keywords：hepatocellular carcinomasurgical treatmentcomprehensive treatmentconversion therapyneoadjuvant therapyimmunotherapytargeted therapyprognosis
Publication Date：2024-09-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 1010-1015 )