肝切除术后肝细胞癌患者管理的最新进展

StephenW

Updates and advancements in the management of hepatocellular carcinoma patients after hepatectomy
Shi-Dong Lu, Lin Li, Xin-Min Liang, Wu Chen, Fu-Li Chen, Lang-Lin Fan, show all
Received 12 Jul 2019, Accepted 21 Oct 2019, Accepted author version posted online: 25 Oct 2019, Published online: 30 Oct 2019

    Download citation https://doi.org/10.1080/17474124.2019.1684898 CrossMark Logo CrossMark




ABSTRACT

Introduction: The 5-year recurrence rate of hepatocellular carcinoma (HCC) after hepatic resection or local ablation is up to 70%. Adjuvant therapies to prevent HCC recurrence have been reported but are not currently recommended by EASL or AASLD guidelines. From randomized controlled trials, meta-analyses and systematic reviews on the safety and efficacy of adjuvant therapies and chemotherapies in HCC patients after resection or local ablation.

Areas covered: PubMed was searched through 15 June 2019. Available evidence was assessed based on the GRADE system.

Expert commentary: Transarterial chemoembolization is the best adjuvant therapy for HCC patients at high risk of recurrence, antiviral therapy with nucleoside analogs is effective for preventing recurrence of HBV-related HCC, and interferon-α is effective for preventing recurrence of HCV-related HCC. Further studies are needed to clarify the efficacy of adjuvant immune checkpoint inhibitors. Adjuvant sorafenib appears to offer negligible clinical benefit and high risk of adverse effects.
KEYWORDS: Adjuvant, hepatocellular carcinoma, hepatic resection, tumor recurrence
Additional information
Funding
This work was supported by the Graduate Course Construction Project of Guangxi Medical University (YJSA2017014), the Foundation Ability Enhancement Project for Young Teachers in Guangxi Universities (2018KY0122), the Guangxi Natural Science Foundation (2018GXNSFBA138018), and 'Guangxi BaGui Scholars' Special Fund .
Article highlights

    Postoperative nucleoside analog therapy is safe and effective to prevent recurrence in patients with HBV-related HCC in Asian.

    Postoperative adjuvant interferon-α is safe and effective to prevent recurrence in patients with HCV-infected HCC.

    Postoperative adjuvant TACE is safe and effective to prevent recurrence in patients at high risk of recurrence in Asian.

    Adjuvant adoptive immunotherapy is safe and effective to prevent HCC recurrence after surgery.

    Adjuvant sorafenib is not an effective therapy to prevent HCC recurrence after surgery.

StephenW

肝切除术后肝细胞癌患者管理的最新进展
卢世栋，李林，梁新民，陈武，陈福立，范郎霖，显示全部
2019年7月12日接收，2019年10月21日接受，在线发布的作者版本：2019年10月25日，在线发布：2019年10月30日

下载引文https://doi.org/10.1080/17474124.2019.1684898 CrossMark徽标CrossMark




抽象

简介：肝切除或局部消融后肝细胞癌（HCC）的5年复发率高达70％。预防HCC复发的辅助疗法已有报道，但EASL或AASLD指南目前不建议使用。通过随机对照试验，荟萃分析和系统评价，对切除或局部消融后HCC患者的辅助治疗和化学疗法的安全性和有效性。

涵盖领域：搜索PubMed直至2019年6月15日。可用的证据基于GRADE系统进行评估。

专家评论：动脉化疗栓塞术是高复发风险HCC患者的最佳辅助治疗，核苷类似物的抗病毒治疗可有效预防HBV相关HCC的复发，而α干扰素可有效预防HCV相关HCC的复发。需要进一步的研究来阐明佐剂免疫检查点抑制剂的功效。佐拉非尼的佐剂似乎提供的临床益处可忽略不计，且不良反应的风险很高。
关键词：佐剂，肝细胞癌，肝切除，肿瘤复发
附加信息
资金
这项工作得到了广西医科大学研究生课程建设项目（YJSA2017014），广西大学青年教师基础能力提升项目（2018KY0122），广西自然科学基金会（2018GXNSFBA138018）和“广西八桂学者专项基金”的支持。 。
文章重点

术后核苷类似物疗法安全有效地预防亚洲人HBV相关性HCC患者的复发。

术后辅助干扰素-α安全有效，可预防HCV感染的HCC患者复发。

术后辅助TACE在亚洲高复发风险患者中是安全有效的，可预防复发。

辅助的过继免疫疗法是安全有效的预防术后肝癌复发的方法。

辅助索拉非尼不是预防术后肝癌复发的有效疗法。