Liver cancer is prone to recurrent metastasis after surgery
After surgical resection of hepatocellular carcinoma, the 5-year recurrence and metastasis rate is as high as 40% to 70%, which is related to the possible presence of microscopic foci of dissemination or multicentric occurrence before surgery, so all patients need to receive close follow-up after surgery.
Once tumor recurrence is detected, depending on the characteristics of the tumor recurrence, there are options for re-surgical resection, local ablation, interventional embolization, radiotherapy, or systemic therapy to prolong patient survival.
Effects of postoperative chemotherapy for hepatocellular carcinoma
So, what is the effect of postoperative chemotherapy for patients with liver cancer?
Hepatic artery chemoembolization
For those at high risk of recurrence (tumor diameter > 5 cm, multiple tumors, or tumors with microvascular cancer thrombi), clinical studies have demonstrated that postoperative interventional embolization chemotherapy can detect and control postoperative microscopic residual cancer in the liver and reduce recurrence to prolong survival [2].
For patients with concomitant portal vein cancer thrombosis, postoperative trans-portal vein placement chemoembolization combined with hepatic artery chemoembolization also prolongs survival.
Sorafenib treatment
A large clinical study found that postoperative sorafenib treatment in patients with early-stage hepatocellular carcinoma did not improve patient survival.
Small clinical studies suggest that postoperative sorafenib treatment may reduce tumor recurrence and prolong survival in patients at high risk of recurrence.
Antiviral therapy
For postoperative patients with hepatocellular carcinoma combined with chronic hepatitis B, antihepatitis B virus therapy is effective in delaying tumor recurrence and metastasis.
Interferon alpha
Although clinical studies suggest that interferon α may reduce recurrence and prolong survival, it remains controversial and is currently recommended only for postoperative patients with hepatocellular carcinoma combined with chronic hepatitis B.
The reported finding that miR-26a expression in hepatocellular carcinoma correlates with the efficacy of adjuvant interferon α therapy also needs further multicenter randomized controlled confirmation.