肝细胞癌术后辅助治疗的进展与挑战  

Advances and challenges in postoperative adjuvant therapy for hepatocellular carcinoma

作　　者：王琳 高远 Wang Lin;Gao Yuan(Department of Hepatobiliary,Pancreatic and Splenic Surgery,Xijing Hospital,Air Force Medical University,Xi′an 710032,China)

机构地区：[1]空军军医大学西京医院肝胆胰脾外科,西安710032

出　　处：《中华消化外科杂志》2025年第2期190-197,共8页Chinese Journal of Digestive Surgery

基　　金：国家杰出青年科学基金(82325007)。

摘　　要：手术切除是肝细胞癌(简称肝癌)最主要的治疗方式,但术后5年复发率为50%~70%。术后辅助治疗是提升手术疗效的重要方式,但由于缺乏高质量循证医学证据,术后辅助治疗能否为肝癌患者带来获益尚未达成共识,且未确立标准的术后辅助治疗方案。随着对肝癌背景治疗、局部治疗、系统治疗方式的不断丰富,以及对各种辅助治疗方式认知的不断深入,来自我国的多项研究表明,针对肝癌复发高危人群行术后辅助治疗可改善预后。但肝癌术后辅助治疗也面临以下挑战,精准选择辅助治疗人群,精准分层复发风险,挖掘分子病理学特征的治疗指导价值以及制订个体化术后辅助治疗方案。Surgical resection is the primary treatment for hepatocellular carcinoma(HCC),with a postoperative recurrence rate of 50%−70%within five years.Postoperative adjuvant therapy may be an important way to enhance surgical outcomes.However,due to a lack of high-quality evidence,there is no consensus on the benefits of adjuvant treatment,nor are there standardized protocols.As our understanding of background,local,and systemic treatments about HCC has evolved,as well as the deepening of understanding of various adjuvant treatment methods,recent studies mainly from China suggest that postoperative adjuvant therapy for HCC patients of high-risk recurrence factors may improve their prognosis.Nonetheless,the postoperative adjuvant therapy of HCC also faces challenges including precise selection of candidates for adjuvant therapy,accurate stratification of recurrence risk,elucidation of the therapeutic value of molecular pathological features,and the development of individualized treatment plans.

关 键 词：肝肿瘤 复发 转移 术后辅助治疗 预后 

分 类 号：R73[医药卫生—肿瘤]