” and other surgery-based comprehensive treatments can significantly improve the survival rate of patients with hepatocellular carcinoma combined with portal vein carcinoma embolism and reduce the recurrence rate of postoperative metastasis. For patients with cancer embolism in inferior vena cava, if it is caused by tumor enlargement and compression and the patients are asymptomatic, they can be treated with TACE only without stent placement and observe whether the tumor can shrink. If the cancer embolism is caused by tumor invasion of the inferior vena cava, it is recommended to place inferior vena cava stent or stent at the same time of TACE, and can be combined with radiation therapy. All these patients, if they can tolerate, are recommended to combine or sequential application of systemic therapy (such as Sorafenib, FOLFOX 4 protocol chemotherapy, application of arsenious acid injection and Chinese medicine, etc.). 4. For patients without vascular invasion, further stratification is based on the number of tumors and the maximum diameter of tumors (all judged based on preoperative imaging results). For patients with more than 4 tumor numbers, TACE is recommended to control the liver tumor, and surgical resection treatment is generally not advisable to be considered first. The above treatment can also be combined with ablation therapy. 5. For patients with 2-3 tumor numbers and maximum tumor diameter >3cm or single tumor >5cm, the survival rate of surgical resection is higher than that of TACE, but it should be noted that some patients cannot be surgically resected because of liver function reserve problem or incomplete envelope, and it is recommended that TACE can be used for these patients. it is necessary to judge whether to choose surgery from both hepatic resection technique and liver function reserve. It is generally accepted that patients with surgical resection should have a Child-Pugh classification score of ≤7. For patients who cannot tolerate or are not suitable for other anti-cancer treatment measures, liver transplantation can also be considered if they meet the UCSF criteria. So far, there is no evidence that TACE can reduce postoperative recurrence and prolong survival time, and TACE may bring complications: such as severe adhesions, gallbladder gangrene, bile duct necrosis and liver abscess, which will increase the difficulty of hepatectomy; therefore, for hepatocellular carcinoma that can be surgically resected, preoperative TACE is in principle not recommended. 6. For patients with single tumor diameter <5cm or tumor number 2-3, tumor For patients with a single tumor diameter <5cm or a number of 2-3 tumors with maximum diameter ≤3cm, surgical resection is firstly recommended for treatment. According to the existing evidence-based medical evidence, ablation can also be considered for patients with tumors ≤3cm in maximum diameter. The advantages of surgical resection are low metastatic recurrence rate and high tumor-free survival rate; while percutaneous ablation has low complication rate, rapid recovery and short hospital stay. Radiation therapy can also be considered for patients who refuse surgery, or for patients with important organ diseases such as heart or lung disease or contraindications to anesthesia who are not suitable for surgery. For patients who cannot tolerate or are not suitable for other anti-cancer treatment measures, liver transplantation can be considered if they meet the UCSF criteria (Annex 2 and Annex 3). (C) Treatment of underlying disease. When choosing treatment for HCC, emphasis should be placed on the treatment of underlying liver disease (chronic hepatitis B, cirrhosis and liver dysfunction), and it is advisable to pay attention to the examination and monitoring of viral load when performing surgical resection or liver transplantation, local ablation, TAI/TACE, radiotherapy and systemic therapy (molecular targeted drug therapy and chemotherapy), and the prophylactic application of antiviral drugs can be considered; at the same time, after hepatectomy In addition, standardized antiviral therapy is also advocated. In conclusion, early detection, diagnosis and treatment of HCC must be given high priority; the principle of standardized and comprehensive treatment should be followed, which emphasizes the importance of taking a multidisciplinary approach based on the underlying disease, the pathological type of tumor, the site and extent of invasion (clinical stage), portal or inferior vena cava thrombosis and distant metastases, combined with the general condition (PS ECOG score) and the functional status of the patient's organs (especially the degree of liver function compensation). We will develop the best individualized treatment plan for patients, and select or combine surgical procedures, hepatic artery intervention, local ablation, radiotherapy, systemic therapy (molecular targeted therapy, chemotherapy, biological therapy, Chinese medicine and antibiotics) in a planned and reasonable manner. In order to avoid inappropriate or excessive treatment, we should select or combine various methods such as surgery, hepatic artery intervention, local ablation, radiotherapy, systemic therapy (molecular targeted therapy, chemotherapy, biological therapy, Chinese medicine and antiviral therapy, etc.) and symptomatic treatment to maximize tumor control, improve overall efficacy, improve patients' quality of life, and achieve the goal of prolonging survival or striving for eradication. Meanwhile, individualized treatment based on molecular typing of hepatocellular carcinoma may be an important direction for future development. Follow-up For patients with hepatocellular carcinoma, regular follow-up through dynamic observation of patients' symptoms, signs and adjuvant examinations (mainly serum AFP and imaging examinations) is emphasized, which should monitor disease development, recurrence or treatment-related adverse effects. It is generally believed that the frequency of follow-up should be every 3-4 months within 3 years after treatment; every 4-6 months during 3-5 years; and can be changed to 6-12 months if it is still normal after 5 years.