Many people have this common sense or experience. Drive a very good power performance of the car, speed often inadvertently exceed the speed limit range, get a ticket to become a routine. The reason for this phenomenon is of course related to the driver’s indifferent awareness of traffic regulations, but it should be mainly attributed to the contradiction between the high-speed performance of the car and the low capacity of the road. At the present stage of liver cancer clinical practice in China, there are also many similar contradictions between technology and reality, and they are an important feature. Sun Wenbing, Department of Hepatobiliary, Pancreatic and Splenic Surgery, West Hospital, Beijing Chaoyang Hospital, Capital Medical University I. The level of liver lobe (segment) resection is getting higher and higher, while the number of those who need it is decreasing. The ability of surgeons to perform lobe (segmental) hepatectomy is close to “perfection. This technology no longer exists in technically restricted areas, and is no longer a “patent” owned by a few hospitals and a few physicians. In contrast, the number of hepatocellular carcinoma requiring resection in China is decreasing, mainly due to the following reasons: (1) the recognition that lobectomy, a highly invasive treatment, can lead to significant liver function damage and its close relationship with prognosis, so this means is chosen more carefully; (2) with the improvement of early diagnosis of hepatocellular carcinoma, the proportion of small hepatocellular carcinoma is increasing. As the long-term efficacy of radiofrequency ablation and other minimally invasive techniques for small liver cancer is comparable to that of lobectomy, more and more people choose minimally invasive treatment; ③ some patients with early liver cancer, such as heavy cirrhosis and poor liver function, should prefer liver transplantation for the “best of both worlds”, which in turn squeezes out some of the “space” for lobectomy “In the past 20 years, China has adopted a series of measures to prevent the spread of viral hepatitis, and the results have become increasingly evident, reducing the incidence of liver cancer from the source. Second, the technology of liver transplantation is becoming more and more mature, while the space to perform it is getting more and more restricted China’s liver transplantation has been developed for more than 10 years, which can be described as fruitful, the main thing is that the technology is becoming more and more perfect, the experience is getting richer, the operation mortality rate has been reduced to a gratifying level, it seems to be said that the time to carry out liver transplantation on a large scale in China is basically mature. In contrast, the number of donors and recipients for liver transplantation in China has decreased significantly, and the space for liver transplantation has become more and more limited. On the one hand, due to the increasingly scientific and rational understanding of the indications for liver transplantation for liver cancer, some more advanced liver cancers are excluded from the queue for liver transplantation; on the other hand, the indications for local treatment and liver transplantation are basically the same, and the former seems to be greater than the latter. “In addition, the government’s management of organ donation is becoming more and more standardized, and the public’s awareness of organ donation is far from mature, resulting in a significant decrease in the number of donors for liver transplantation in China. Third, there are more and more means to treat liver cancer, but the comprehensive application level needs to be improved At this stage, liver cancer patients often have this situation. Although the four consultation rooms are only a stone’s throw away from each other, they may get four different treatment plans. Interventional physicians recommend interventional embolization, professors of surgery recommend hepatectomy, specialists specializing in local treatment prefer radiofrequency ablation, and transplant physicians see liver transplantation as the best option. Theoretically, there should be only one optimal treatment option for an individual patient. However, the development of medicine has led to the subdivision of disciplines, and physicians have their own specialties and expertise in their specialties, which are limited by the lack of knowledge and perspective, and they are more familiar with their respective specialties and more trustful, so it is not surprising that the above-mentioned scene of “the king’s wife selling her paws and selling herself” occurs. This irrational state of “following physician’s specialty in treating liver cancer” often makes patients confused and at a loss, and even suffer losses and sacrifices. To fundamentally change this situation, the most important thing is to popularize the application of scientific and advanced liver cancer treatment concepts, standardize clinical practice with unified thinking, and improve the comprehensive treatment level of liver cancer. Technical arguments are intensifying, but not enough attention is paid to non-technical factors affecting prognosis The efficacy of liver cancer is of course closely related to treatment technology, but it is by no means the only factor, nor does it seem to be the most important one. The outcome of hepatocellular carcinoma is closely related to its pathological stage and size. Generally speaking, small hepatocellular carcinoma can be treated in almost any way and can be treated through minimally invasive treatment with efficacy comparable to liver resection and liver transplantation, avoiding the high risk and high cost of surgical treatment; if treated correctly, the 5-year survival rate of small hepatocellular carcinoma patients can be expected to be over 90% and many can survive for a long time. On the contrary, the expansion of the peri-cancerous venous infiltration zone, the formation of portal vein thrombosis, and metastasis inside and outside the liver limit the application of various therapies and often leave physicians at their wits’ end. It is evident that early diagnosis seems to be a more important aspect to obtain satisfactory outcome for patients with hepatocellular carcinoma. Unfortunately, in the past 20 years or so, public awareness of early diagnosis of liver cancer in China has not been significantly improved, and there has been no substantial breakthrough in screening methods. This is in stark contrast to the increasingly intense “Huashan Jian” on the technical level. In conclusion, due to the substantial improvement of technology level in the past 10 years, the collision between technology and reality has become an important feature of liver cancer clinical practice in China at this stage. In contrast, the enhancement of conceptual platform has become a weak link that needs to be strengthened. For the treatment of liver cancer, technological progress is undoubtedly a good thing, but it is never the most important thing. It seems to be more important to guide the practice with scientific and advanced concepts. Technology, like car nature, is irrational; concept, like the driver’s awareness of traffic regulations, is rational. The fast car that lacks rational driving is like a runaway horse, which is dangerous. The harmony of concept and technology is the goal we pursue.