Indications and Contraindications for Surgical Exploration of Liver Cancer

  Liver cancer is the third most common malignant tumor after gastric cancer and esophageal cancer in terms of mortality rate. The initial symptoms are not obvious, and the late symptoms mainly include liver pain, weakness, emaciation, jaundice and ascites. Clinically, the combination of surgery, radiotherapy and traditional Chinese medicine is usually adopted in western medicine, but the cure rate of late stage patients is low due to the spread of cancer cells, so it is necessary to achieve early detection, early diagnosis and early treatment of liver cancer.  Radical resection means complete resection of tumor, no residual cancer in the remaining liver, no cancer thrombus in the portal vein, AFP turns negative and does not reappear 2 months after surgery, and no residual tumor or recurrence is seen on imaging. The 5-year survival rate was reported to be around 50% in the literature.  The indications and contraindications of hepatocellular carcinoma surgery are as follows  2.Recurrent hepatocellular carcinoma that is more limited after radical resection and is estimated to have the possibility of resection.  3.After comprehensive treatment, the tumor has shrunk significantly and is estimated to have the possibility of resection.  Liver function is normal or in compensatory stage. Total plasma protein is around 60g/L, plasma albumin is more than 30g/L, the ratio of total serum protein to globulin is 3-2:1, glutathione aminotransferase is normal (sometimes it can be slightly higher, but not more than 1 times the normal value), prothrombin time is more than 50% of the normal value; there is no xanthogranuloma, ascites, swelling of lower limbs caused by liver failure.  For obstructive jaundice caused by compression of the bile duct by small hepatocellular carcinoma in the first hepatic portal, in individual cases, surgical exploration can still be considered. There are no other contraindications, such as serious heart, lung, kidney and hematological system diseases, uncontrolled diabetes mellitus, etc.  (2) Contraindications for hepatocellular carcinoma surgery 1. Tumor is too large and the remaining liver is less.  2.Tumor is widely spread or scattered in multi-nodular type.  3.The presence of cancer thrombus in the main trunk of portal vein.  4.With extensive distant metastasis.  5.Liver function loss, obvious xanthogranuloma, ascites and cachexia.  6.Severe heart, lung and kidney dysfunction, unable to tolerate surgical exploration.