Hepatocellular carcinoma needs to be prevented from metastatic recurrence after surgery

  In China, about 344,000 people die from liver cancer every year, accounting for 55% of the world’s liver cancer deaths. This is because the detection rate of early stage liver cancer are low, and more than 80% of them are middle and late stage once detected, and their survival period is mostly within 6 months. For the big treatment of liver cancer is a challenge. In order to improve the survival rate of liver cancer patients and reduce the recurrence rate of liver cancer patients after surgery, a series of comprehensive treatment methods should be combined with surgical treatment to better deal with liver cancer.  For most liver cancers, the efficacy of any single treatment method is very limited, but the simultaneous application of two or more treatment methods, which is called ‘multidisciplinary comprehensive treatment’, is the necessary way to treat liver cancer.  In clinical practice, a considerable number of liver cancers recur after surgical resection. It can be said that the low rate of surgical resection and the high rate of postoperative recurrence have become the clinical standard. For some types of liver cancer, such as a large cancer with other small lumps scattered next to it, surgery alone cannot cut cleanly and often has poor results. At this time, surgical resection + intraoperative radiofrequency ablation treatment can be used to achieve very ideal results. Wu Peihong said, this treatment is to remove the main cancer foci and then ablate other small masses with radiofrequency to completely remove the cancer. This method is very suitable for patients who have obvious cirrhosis and should not have too much liver tissue removed.  2.Surgical resection + anhydrous alcohol coagulation therapy For patients whose cancer is close to major blood vessels or bile ducts, radiofrequency or microwave ablation therapy may cause accidental injury. In this case, anhydrous alcohol coagulation therapy can be used. In this case, anhydrous alcohol coagulation therapy is used to kill the tumor by injecting an anhydrous alcohol under the guidance of ultrasound or CT by puncturing an injection needle into the tumor. It can be performed either immediately during surgery or postoperatively depending on tumor metastasis or recurrence.  3.Surgical resection + postoperative hepatic artery chemoembolization + comprehensive treatment Many liver cancers have intrahepatic metastases at the time of surgery. Although the surgical resection has removed the visible cancer nodes, some tiny cancer foci may still remain, which become the root cause of future recurrence. Therefore, for patients with high recurrence tendency after surgery (such as huge tumor), postoperative treatment with hepatic artery chemoembolization, radiofrequency or microwave ablation, alcohol injection, radioactive particle implantation, chemotherapy, radiotherapy, biotherapy, immunotherapy, Chinese medicine treatment and other comprehensive treatments can help reduce the chance of recurrence and improve the survival rate.  4.Palliative surgery + comprehensive treatment for unresectable liver cancer In clinical practice, patients with liver cancer that cannot be surgically resected account for about 50%. For these cases, the combination of palliative surgery and comprehensive treatment will also give many patients a chance of long-term survival with tumor. It is understood that palliative surgical treatment includes intraoperative hepatic artery ligation, hepatic artery chemoembolization and so on. And the comprehensive treatment includes radiofrequency or microwave ablation, alcohol injection, radioactive particle implantation, etc.  What should be done to prevent metastasis after liver cancer surgery Liver cancer is the third most common malignant tumor after gastric cancer and esophageal cancer in terms of mortality rate. The initial symptoms are not obvious, and the late symptoms mainly include liver pain, weakness, emaciation, jaundice, ascites and other symptoms. Clinically, the combination of surgery, radiotherapy and traditional Chinese medicine is generally adopted in western medicine, but the cure rate of advanced stage patients is low due to the spread of cancer cells, so it is necessary to achieve early detection, early diagnosis and early treatment of liver cancer.  Recurrent metastasis of hepatocellular carcinoma is one of the keys to affect patient’s efficacy and obtain long-term survival, which is the current hot spot of hepatocellular carcinoma research. The detection pathway and treatment principles of subclinical recurrent metastasis after hepatectomy are basically similar to those of subclinical hepatocellular carcinoma. Regular and long-term postoperative follow-up is extremely important. Usually, it is reviewed every 2 to 3 months within 2 years after surgery, and every 3 to 6 months afterwards. The review mainly includes AFP, ultrasound, X-ray chest X-ray, CT, MRI, etc. if necessary. Re-operation is the main treatment method.  Chemotherapy for liver cancer is the most basic and important tumor treatment. Through standardized and effective chemotherapy, tumor cells can be killed to different degrees and the tumor load can be minimized. However, the toxic side effects of chemotherapy increase with increasing dose. Complementary cellular immunotherapy can, on the one hand, kill residual cancer cells in the body and prevent tumor recurrence, and at the same time, improve the immunity of the body, increase the compliance to chemotherapy and radiotherapy, and prolong the disease-free survival of patients. In this sense, tumor surgery, chemotherapy, radiotherapy and immunotherapy are all part of the overall comprehensive tumor treatment, complementing each other.