Factors Affecting the Curative Effect of Liver Cancer There are many and various clinical treatment methods for liver cancer, and each hospital has certain preferences in treatment tradition. Some hepatocellular carcinoma patients have good treatment effect, while others have unsatisfactory treatment results. We believe that the following factors affect the clinical efficacy of hepatocellular carcinoma. 1. The concept of liver cancer treatment. Liver cancer is not only a local lesion, but also a systemic lesion. Therefore, it is emphasized that the treatment of liver cancer should mostly be integrated, multidisciplinary and multi-method combination. The effect of single treatment method is poor. The diagnosis and treatment of hepatocellular carcinoma requires close collaboration among hepatobiliary surgery, hepatology, medical oncology, interventional medicine, diagnostic imaging and other disciplines. Multiple methods include surgical resection (including liver transplantation), radiofrequency ablation (RFA), argon helium knife cryoablation, percutaneous transhepatic artery embolization chemotherapy (TACE), radiotherapy (including image localized radioactive particle placement), chemotherapy and so on. One is the integrated and sequential application of different methods of tumor elimination (surgical resection, local ablation, TACE, etc.), and the removal of large hepatocellular carcinoma after reduction by TACE, which is called “hepatocellular carcinoma reduction after resection”, is a typical example of integrated and sequential application. The second is the integrated and sequential application of eliminating liver cancer and regulating tumor and immunity. For example, resection of tumor + immune enhancer, various methods of tumor elimination + antiviral (hepatitis B or C virus) treatment, tumor removal + anti-cancer drugs (including traditional Chinese medicine), etc. 2.Early diagnosis and early treatment. China has carried out hepatocellular carcinoma resection since 1970s, and more than 30 years of clinical experience shows that small hepatocellular carcinoma (hepatocellular carcinoma with diameter less than 3cm or smaller) has good clinical effect after surgical resection. In fact, for the treatment of any cancer, the International Union Against Cancer still puts forward the slogan “early detection saves lives”. This is especially true for liver cancer. In China, 90% of liver cancer patients are developed on the basis of hepatitis B cirrhosis, therefore, patients with hepatitis B who are older than 40 should have regular ultrasound, CT and blood AFP checks, and if liver cancer is detected when it is still small, surgical resection or liver transplantation or local ablation will give most patients a good prognosis and long-term survival. 3.Experience and technology of hepatocellular carcinoma resection. Surgical resection of hepatocellular carcinoma is still the most basic and effective method to treat hepatocellular carcinoma in current clinical practice. Complete resection of liver cancer lesions has good therapeutic effect and patients and their families are more relieved. However, even if the same liver cancer is removed, some patients have recurrence after surgery while others have better results. This is related to the surgical technique and experience of the surgeon. Our experience shows that intraoperative blood loss has a certain relationship with postoperative complications, liver function status, recovery time and long-term survival rate; intraoperative moving and squeezing of liver cancer can cause hematologic metastasis of cancer cells, etc. Therefore, precision hepatectomy is currently emphasized, i.e. the integrated application of hepatic blood flow blocking technology, intraoperative ultrasound, portal vein puncture staining, etc., to dissect the hepatic veins of the liver lobe segments as the center, complete resection of the lesion and maximum preservation of the residual liver blood supply and blood outflow tract and bile duct. In recent years, our department has widely carried out “fenestration” surgery for liver cancer, which can not only reduce intraoperative bleeding, but also effectively avoid blood spreading of liver cancer cells caused by moving and squeezing the tumor during surgery, which has achieved good clinical results. 4.Individualized treatment. For patients with liver cancer, appropriate treatment methods should be selected according to patients’ liver cancer, liver function, general condition and even economic situation. Small hepatocellular carcinoma can be surgically resected or liver transplantation; unresectable hepatocellular carcinoma is feasible for intervention or minimally invasive ablation; advanced hepatocellular carcinoma with good economic condition can be treated with Sorafenib (sorafenib), etc. Without considering patient’s specific conditions and treatment, it often backfires and not only fails to cure or prolong the life of the patient, but also shortens the survival time of the patient. 5.Actively prevent recurrence of liver cancer after surgery. It is one of the important reasons why liver cancer is so scary that it is prone to recurrence after surgical resection. This is related to the rich blood supply of liver, easy invasion of portal vein and hepatic vein by hepatocellular carcinoma, failure of imaging examination or intraoperative detection of microscopic lesions, and the fact that most of the patients with hepatocellular carcinoma in China have hepatitis B cirrhosis, and after surgical resection or other treatment of hepatocellular carcinoma, their numerous cirrhotic nodules can easily become new hepatocellular carcinoma. Therefore, postoperative patients with liver cancer should still be reviewed regularly to detect recurrent liver cancer at an early stage and treat it actively, which can still achieve good results. Taking anti-cancer drugs and applying immune enhancers and anti-viral drugs after surgery can reduce the recurrence rate of hepatocellular carcinoma after resection or ablation.