1.Multidisciplinary therapy for gastric cancer with liver metastasis.
Lin CHEN ; Hongqing XI ; Weisong SHEN
Chinese Journal of Gastrointestinal Surgery 2014;17(2):101-104
Gastric cancer with liver metastasis (GCLM) is the leading cause of death in patients with advanced gastric cancer. Multiple metastasis was common in GCLM and usually complicated with lesions outside the liver, especially peritoneal metastasis. Most of liver metastasis lesions could not be resected radically. Currently, main treatments for GCLM included radical operation, palliative resection of gastric cancer, ablation of metastatic lesions, intervention and systemic chemotherapy. Based on the current progress in the treatment for GCLM and our clinical experience, the general status of patients, the type of gastric cancer and the degree of liver metastasis should be analyzed, and a cooperative multidisciplinary team (MDT) should be applied to conduct and to choose active and suitable comprehensive treatment for GCLM patients based on individualized therapy principle.
Humans
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Liver Neoplasms
;
secondary
;
therapy
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Stomach Neoplasms
;
pathology
;
therapy
2.Status and challenges of neoadjuvant immunotherapy for hepatocellular carcinoma.
Yong Xiang XIA ; Heng Song CAO ; Wei Wei TANG ; Xue Hao WANG
Chinese Journal of Surgery 2023;61(1):7-12
With the development of modern liver surgical techniques and the progress of perioperative management,the survival rate after resection of hepatocellular carcinoma has been greatly improved,but the high recurrence and metastasis rate still limits the long-term survival after surgery. Preoperative neoadjuvant therapy has been confirmed to significantly reduce the postoperative recurrence rate and prolong survival in other types of cancer,but there has been a lack of effective systemic therapy for hepatocellular carcinoma for a long time,so the efficacy and regimen of neoadjuvant therapy for hepatocellular carcinoma are still controversial. PD-1/PD-L1 monoclonal antibody combined with anti-angiogenic targeted drugs has become a first-line regimen in systemic therapy for advanced hepatocellular carcinoma. This regimen has definite efficacy and high safety,bringing hope for neoadjuvant therapy of hepatocellular carcinoma. Recently,three clinical trials of neoadjuvant immunotherapy for hepatocellular carcinoma have been published internationally,which preliminarily suggest the efficacy and safety of neoadjuvant immunotherapy for hepatocellular carcinoma and lay a solid foundation for carrying out larger sample clinical studies in the future.
Humans
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Carcinoma, Hepatocellular/pathology*
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Neoadjuvant Therapy
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Liver Neoplasms/pathology*
;
Immunotherapy
3.Management of liver metastases of gastrointestinal stromal tumor.
Chinese Journal of Gastrointestinal Surgery 2012;15(3):221-224
Liver is the most common metastatic site of gastrointestinal stromal tumor(GIST). The recurrence rate is high even after hepatectomy. Although tyrosine kinase inhibitors (TKI) makes the resection feasible for some of the liver metastasis of GIST and significantly increase the overall survival, surgery still can not be substituted. Therefore, it is worth investigating and exploring the most appropriate treatment for the GIST with liver metastasis.
Gastrointestinal Stromal Tumors
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pathology
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therapy
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Humans
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Liver Neoplasms
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secondary
;
therapy
4.Considerations on the therapy of colorectal cancer liver metastasis in China.
Chinese Journal of Gastrointestinal Surgery 2012;15(10):993-996
The liver is the most common site of colorectal cancer metastasis(CRLM). The importance of how to treat CRLM has attracted attention from doctors world wide and specific academic organization and expect consensus has been established. Relative principals of treatment of CRLM also developed in China, for example, guideline of diagnosis and treatment of colorectal cancer liver metastasis(draft) and standard for diagnosis and treatment of colorectal cancer, which were established in 2008 and 2010, respectively. However, we found that the Chinese doctors still understand these treatment policies inadequately, and easily produce deviation on the treatment progress. Based on the problems of current CRLM treatment, we have some thoughts or suggestions as follows: (1)Promoting the core conception of CRLM treatment actively: surgery is the only method to achieve possible cure of the CRLM. (2) Evaluating the status of new adjuvant chemotherapy for CRLM dialectically. (3)Paying attention to multi-disciplinary team(MDT): MDT is the scientific treatment foundation of CRLM. (4)Changing the treatment conception of primary tumor of CRLM: radical resection of primary tumor is essential for the resectable CRLM.(5)Emphasizing the surgical treatment of CRLM combined with lung metastasis. (6)Do not neglect the safety of patients, when we emphasize the surgery is the optimal treatment of CRLM. These guides of treatment of CRLM will improve the outcomes of CRLM around the world, but we still need pay attention to above mentioned points in order to insure the standardization and scientification of CRLM therapy.
China
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Colorectal Neoplasms
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pathology
;
therapy
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Combined Modality Therapy
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Humans
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Liver Neoplasms
;
secondary
;
therapy
5.Establishment and promotion of multi-disciplinary treatment for colorectal liver metastases.
Chinese Journal of Gastrointestinal Surgery 2014;17(11):1060-1061
Liver metastasis is very common in colorectal cancer and it can be effectively treated today. Multiple clinical disciplines would be involved to effectively treat liver metastasis of colorectal cancer. The multi-disciplinary treatment (MDT) is required in most clinical diagnosis and treatment guidelines from different organization or countries including China. The basic requirement of establishment, organization and running on MDT of colorectal cancer liver metastases is proposed in this paper.
China
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Colorectal Neoplasms
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pathology
;
therapy
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Combined Modality Therapy
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Humans
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Liver Neoplasms
;
secondary
;
therapy
;
Treatment Outcome
6.Consideration of therapy for colorectal cancer with synchronous unresectable liver metastasis.
De-xiang ZHU ; Li REN ; Jian-min XU
Chinese Journal of Gastrointestinal Surgery 2013;16(8):718-720
A variety of managements, including systemic and local chemotherapy, radiofrequency ablation and others, are used after multidisciplinary team discussion to improve the survival of patients with unresectable liver metastasis, and to enlarge the cohort of patients who can be managed with curative intent. Patients should be divided into different clinical groups according to characteristics of the patient and tumor, and then receive different treatments. For the patients who may be converted to be resectable after chemotherapy, we should choose efficient convertible chemotherapy with short courses to get the best response rate. For KRAS wild-type patients, cetuximab combined with FOLFOX/FOLFIRI, in which 5-fluorouracil is continuously infused, is recommended. In addition, resection of the primary tumor is recommended at the right time for asymptomatic patients with unresectable liver metastases. There is no consensus on the preferred treatment modality for systemic and local therapies.
Colorectal Neoplasms
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drug therapy
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pathology
;
surgery
;
therapy
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Humans
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Liver Neoplasms
;
drug therapy
;
secondary
;
surgery
7.Introduction to the recommendations from the European Association for the Study of the Liver clinical practice guidelines on the management of cystic liver disease.
Chen LIANG ; Su Jun ZHENG ; Zhong Ping DUAN
Chinese Journal of Hepatology 2022;30(9):931-933
The diagnosis of cystic liver disease has made great progress with the advent of enhanced imaging techniques. At the same time, its management has gradually improved over the past few decades, providing the basis for the development of appropriate diagnostic and treatment guidelines. To this end, the European Association for the Study of the Liver has developed clinical guidelines for the diagnosis and treatment of non-infectious cystic liver disease. This guideline put forward recommendations based on an in-depth review of the relevant literature for addressing clinical issues, including the diagnosis and treament of hepatic cysts, hepatic mucocystic tumors, biliary hamartomas, polycystic liver disease, Caroli disease or Caroli syndrome, biliary hamartomas, and peribiliary cyst.
Humans
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Liver Diseases/pathology*
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Cysts/pathology*
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Caroli Disease/diagnosis*
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Liver Neoplasms/therapy*
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Hamartoma
8.Microcirculation of liver cancer, microenvironment of liver regeneration, and the strategy of Chinese medicine.
Chinese journal of integrative medicine 2016;22(3):163-167
Microcirculation of liver cancer is the micro-vascular system which comes from the tissue of liver cancer. It can offer the nutritional requirement for accelerating the cancer cell proliferation and metastasis. The intrinsic mechanism of angiogenesis is the key link in the formation of liver cancer microcirculation system. Liver regeneration microenvironment also plays an important role in the construction of liver cancer microcirculation, through the improvement of liver regeneration microenvironment affecting tumor microcirculation is the new strategy of prevention and treatment of liver cancer. In recent years, it is found that many kinds of Chinese medicine can inhibit angiogenesis, decrease the microvessel density, and delay or prevent the development of liver cancer.
Humans
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Liver Neoplasms
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drug therapy
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pathology
;
therapy
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Liver Regeneration
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Medicine, Chinese Traditional
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Microcirculation
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Tumor Microenvironment