Several outstanding issues for conversion therapy of liver cancer
In recent years,the advancements of systemic and local treatments have catalyzed transformations in the diagnostic and therapeutic paradigms for hepatocellular carcinoma.The traditional"surgery-first"philosophy of prioritizing surgery has gradually evolved into a"strategy-first"approach of treating surgery as a foundation.Various novel therapeutic approaches have been formulated for achieving optimal outcomes.And conversion therapy for liver cancer has played some vital roles in this evolution.This approach has opened up surgical opportunities for patients initially deemed unresectable with poor prognostic expectations.It involves preliminary preoperative interventions for better oncological outcomes.Conversion therapy of liver cancer is a hot research area.However,its clinical applications still have some contentious issues.For instance,how can we scientifically and individually tailor neoadjuvant therapy for patients?Is surgery always necessary for patients with a successful conversion?What is optimal operative timing for ensuring the best therapeutic outcome?How can hepatic artery infusion chemotherapy(HAIC)be judiciously utilized for maximizing the benefits of conversion?And how can we scientifically evaluate and employ treatments of promote the growth of future liver remnant(FLR),such as terminal branches portal vein embolization(TB-PVE)or associating liver partition and portal vein ligation for staged hepatectomy(ALPPS)?This review provided a preliminary discussion of these common concerns.
万方数据
维普
