Comprehensive interventional therapy for primary liver cancer

Primary liver cancer has been called “the king of cancers” mainly because only about 1/5 of the patients have the chance of surgical resection when primary liver cancer is detected, and the remaining 4/5 of the patients tend to have only 3-6 months of survival, thus it has been called “the king of cancers”. Therefore, it is called “the king of cancers”. Interventional therapy can effectively control the development of lesions through vascular embolization technology, local ablation technology combined with molecular targeted drug therapy and other comprehensive therapeutic techniques. Portal stenting and particle implantation technology can solve the problem of portal vein thrombosis, and transjugular vein-portal vein shunt can solve the symptoms of portal hypertension (such as vomiting blood, ascites, abdominal distension, etc.) due to hepatocellular carcinoma and liver cirrhosis. After the emergence of interventional therapy, the survival period of the remaining 4/5 patients has been significantly prolonged, thus getting rid of the hat of “the king of cancers”. Primary liver cancer is a preventive disease, and patients with early detection have a high postoperative survival rate, but once it reaches the middle or late stage, the effectiveness of treatment is greatly reduced. For Chinese patients, the vast majority of them have concomitant hepatitis, especially hepatitis B and C. Therefore, patients with hepatitis B should undergo hepatitis B and C screening. Therefore, patients with hepatitis B should undergo hepatitis B virus DNA test, and if the count is >103, they should adhere to antiviral treatment for a long period of time. It is recommended that liver ultrasound should be performed once every 3 months or so, which is convenient and affordable, in order to detect and treat the disease at an early stage, in addition, patients should quit smoking, alcohol, spicy and irritating food to reduce the burden on the liver, and liver preservation treatment should be given in time when the liver function indexes are abnormal. When hepatocellular carcinoma is found, if the opportunity of surgical treatment is lost, current evidence-based medical evidence shows that hepatic interventional therapy should be preferred, that is, hepatic artery perfusion chemoembolization, and according to the situation of interventional therapy, combined with local ablation therapy, which involves the interventional therapy of “perfusion” “blockage” and “ablation”. This involves interventional “irrigation”, “blockage” and “elimination” techniques, which are local treatment means. According to the staging of patients’ conditions, systemic treatment with molecular targeted drugs should also be considered, so as to achieve a perfect combination of local and systemic treatment. When there are complications of liver cancer, such as portal hypertension caused by liver cancer and cirrhosis (e.g. vomiting blood, ascites, abdominal distension, etc.), the cause of portal hypertension is due to cirrhosis or portal vein thrombosis, which leads to poor blood flow from intestines to liver, and intestinal stagnation causes abdominal distension and ascites, and the blood is diverted to esophageal vein in the bottom of the stomach, which makes blood vessels of the stomach wall varicose, and bleeding when the pressure is too high, which causes vomiting of blood, just as the downstream of the river is blocked, which leads to river water. This is just like the downstream blockage of a river, which will cause the river to burst its banks and flood. Interventional therapy can open a channel between portal vein and hepatic vein in the liver through the technique of “pass”, which is equivalent to establishing a dredged river channel to introduce the blood into the inferior vena cava system and return to the heart, so as to reduce the pressure of the portal vein and alleviate the symptom of portal hypertension. The presence of cancer thrombus in portal vein not only increases the pressure of portal vein, but also seriously affects the survival time of patients. Interventional therapy places metal stents and radioactive particles inside the portal vein through the technique of “through”, the stents open the blood flow in the portal vein, and the particles inhibit the growth of cancer thrombus through continuous close-range irradiation, thus prolonging the survival time of patients. Various techniques of interventional therapy have effectively prolonged the survival period of patients with middle and late stage liver cancer and brought new light of life to liver cancer patients.