The complete ablation rate of primary hepatocellular carcinoma treated with “triple-targeted” therapy is close to 100%, and the recurrence rate after surgery is reduced by 80%. Figure 1: Patient, male, 52 years old. Hepatitis B, cirrhosis, and primary liver cancer in the right lobe of the liver recurred locally one year after surgical resection in a cancer hospital, with progressive elevation of alpha-fetoprotein. He was treated with radiofrequency ablation of primary hepatocellular carcinoma again, and the elevation of methemoglobin was still rapid. The patient was desperate. Pre-operative strategy analysis of minimally invasive “triple targeting” treatment without opening the abdomen: 1. Local physical ablation and targeted therapy to remove visible primary liver cancer (radiofrequency ablation, microwave ablation, cryoablation); 2. Systemic small molecule targeted therapy drugs for primary liver cancer to prevent metastasis and improve local therapeutic effect (Dodgemet); 3. microscopic primary liver cancer at the cellular level in the body to prevent the recurrence of primary liver cancer (Licartin). In addition, hepatoprotection, antiviral therapy, medication and splenic embolization (or thermal ablation) are given to improve the patient’s immunity. Figure 2: Super-selection of the right hepatic lobe artery for local targeted therapy chemoembolization of the tumor to block the blood supply to the primary hepatocellular carcinoma. Postoperative angiography and CT showed occlusion of the main trunk and branches of the tumor blood supply artery, and the tumor parenchyma was filled with a large amount of embolic agent. Preoperative and postoperative oral doxorubicin was insisted to suppress the level of tumor growth factor in the body to prevent tumor metastasis and improve the efficacy of embolization therapy. Figure 3: CT-guided, minimally invasive targeted therapy physical ablation procedure with multi-point fusion, targeted tumor resection and AFP reduction to normal level. Figure 4: After minimally invasive targeted resection of primary hepatocellular carcinoma, review of enhanced CT shows complete tumor necrosis with adequate ablation margins. Figure 5: After super-selective hepatic lobe artery cannulation to inject Licartin, which binds to the cell surface antigen of primary hepatocellular carcinoma, radiotherapy is administered to the microscopic lesions with its bound isotope. Targeted therapy removes microscopic hepatocellular carcinoma at the cellular level in vivo, prevents tumor recurrence, stabilizes the long-term efficacy of minimally invasive treatment, reduces the number of hospitalizations, improves the patient’s quality of life, and reduces AFP to normal and lives as usual. Figure 1, before minimally invasive treatment Figure 2, local targeted chemoembolization therapy, along with oral targeted therapy drug doxorubicin (sorafenib) for primary liver cancer Figure 3, minimally invasive targeted surgery, local targeted resection of primary liver cancer (radiofrequency, microwave or freezing) Figure 4, minimally invasive targeted therapy, precise resection of primary liver cancer without incision after surgery, complete necrosis of tumor and adequate ablation margin Figure 5, hepatic artery cannula injection of lycopodium Tintin, targeted therapy for primary liver cancer at the cellular level to prevent recurrence
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