摘要
根治性肝切除是改善早中期肝癌患者预后的主要治疗手段。我国大部分肝癌患者在初诊时已为晚期,失去了手术治疗的机会。因此,临床上将不可切除肝癌转化降期为可切除肝癌尤为重要,这是延长患者生存期的重要途径,也是目前临床研究的热点。近年来,随着肝癌有效治疗手段的增多,不可切除晚期肝癌转化手术的切除率得到明显提高,越来越多的患者从转化治疗中获益。本文主要对肝癌转化治疗的内涵、适合转化人群的筛选、转化策略的选择,以及序贯手术的时机、方案及安全性等方面进行综述。
Radical hepatectomy is the well-established and highly effective therapeutic tool for early-and middle-stage hepatocellular carcinoma(HCC)to improve the survival.However,the majority of HCC patients in China are not amenable to surgical excision due to the advanced tumor stage at the initial diagnosis.Therefore,it is the bottom line to convert and downstage unresectable tumor into resectable tumor in clinical practice,which is an important means for improving patient survival rate and is currently a clinical research focus as well.In recent years,the rate of conversion surgery for unresectable advanced HCC has achieved dramatic improvement thanking to the accumulating effective therapeutic arsenals,and an increasing number of patients benefit from conversion therapy.Herein,several clinically relevant issues on conversion therapy for HCC were discussed in this review,including the definition of conversion therapy,the optimal selection of patients as well as conversion strategy,and the timing of sequential surgery together with strategy and safety of surgery.
作者
骆亿
丁国善
董家勇
Luo Yi;Ding Guo-Shan;Dong Jia-Yong(Department of Organ Transplantation,the Affiliated Changzheng Hospital of Naval Medical University,Shanghai 200003,China)
出处
《解放军医学杂志》
CAS
CSCD
北大核心
2022年第7期731-738,共8页
Medical Journal of Chinese People's Liberation Army
基金
国家自然科学基金(81871262)。
关键词
肝癌
不可切除肝癌
转化治疗
降期
hepatocellular carcinoma
unresectable hepatocellular carcinoma
conversion therapy
downstaging
