How to treat primary liver cancer

Primary liver cancer is one of the most common malignant tumors in China. According to the statistics of the Ministry of Health, about 130,000 people die of liver cancer in China every year, and its death rate has risen to the second place among malignant tumors, and some areas with high incidence of liver cancer have jumped to the first place. Because of the insidious onset of liver cancer, most patients are asymptomatic, and when clinical symptoms appear, the disease is already at an advanced stage, and the survival time is only 1-3 months on average. For patients who are already known to be suffering from hepatitis and cirrhosis, annual physical examination is essential. If the tumor is detected early, timely and effective treatment can often significantly increase the survival time and improve the quality of life. 1.Surgical treatment: For single small tumor, surgical resection is the treatment of choice. For patients with severe cirrhosis combined with small hepatocellular carcinoma, liver transplantation can also be considered when economic conditions allow. However, many patients are found to have recurrence of tumor on the residual liver or metastasis of intrahepatic tumor several months after surgery, so interventional treatment should be preferred at this time; 2. Studies in Japan have shown that there is no significant difference in the survival rate between surgical resection and interventional treatment for small hepatocellular carcinoma, which means that the same effect of surgery can be fully achieved by using comprehensive interventional treatment methods. There are many interventional treatment methods, among which the classic one is endovascular hepatic artery chemoembolization, which is a local embolization of the tumor supply artery to cause necrosis of tumor cells and achieve the treatment purpose. At present, there are also techniques such as transarterial injection of isotope radiation particles, which cause necrosis of tumor cells by internal irradiation of tumor cells. There are also techniques such as intra-tumor thermotherapy. Besides transvascular route, early sclerotherapy with percutaneous injection of alcohol and other drugs can treat smaller tumors. In recent decade, there are also percutaneous direct puncture to tumor and thermal therapy methods such as multipolar radiofrequency thermal therapy, microwave thermal therapy, etc. Cold therapy such as argon helium knife cryoablation therapy, which is to rapidly cool down the tumor and some surrounding normal liver tissues to minus 270 degrees for a short time, and then re-temperature to make tumor cells necrosis. Radiofrequency therapy can achieve partial hepatectomy and has been widely used in the treatment of substantial organ tumors. Focused ultrasound therapy is a new technology recently applied in clinical practice, which can also achieve certain therapeutic purposes for tumors. Interventional techniques play a pivotal role in the treatment of advanced hepatocellular carcinoma, such as fistula blocking treatment for hepatic artery-portal fistula and hepatic artery-hepatic vein fistula, transjugular portosystemic shunt to relieve portal vein pressure, and inferior vena cava stenting to open the compressed inferior vena cava, which can prolong patients’ lives. 3.Drug therapy: The research on drug therapy for liver cancer has never stopped, and now it is mostly used as the adjuvant therapy or comprehensive therapy of the above two methods. Besides immune-enhancing drugs, gene therapy and anti-tumor angiogenesis therapy are hot methods. At present, anti-tumor angiogenesis drugs such as domestic Endo (recombinant human vascular endothelial inhibitor injection, Endostar) and German-made Doxorubicin (sorafenib tablets) have been used in clinical practice, especially Doxorubicin tablets, which can be taken orally, bringing convenience to patients. The drug is now proved to have targeted inhibition of tumor growth, inhibition of tumor neovascularization growth, with clear inhibitory effect on kidney cancer and liver cancer, and prolong the survival time of patients. In conclusion, the comprehensive treatment of primary liver cancer has greatly prolonged the survival time of patients, and the integrated use of new technologies and methods of intervention can achieve the same effect of surgery, which can significantly reduce the pain of patients.