1.Interpretation of critical update: AASLD practice guidance on prevention, diagnosis, and treatment of hepatocellular carcinoma
Yuze ZHAO ; Yuxiao CHEN ; Kechun WANG ; Mingda WANG ; Tian YANG
Journal of Clinical Hepatology 2025;41(5):851-854
In February 2025, the American Association for the Study of Liver Diseases (AASLD) published online “Critical Update: AASLD Practice Guidance on Prevention, Diagnosis, and Treatment of Hepatocellular Carcinoma”. This update mainly focuses on the latest analysis results of the IMbrave050 study and performs corresponding updates and adjustments to recommendations based on the issues in clinical practice. As for the postoperative adjuvant therapeutic strategies for hepatocellular carcinoma (HCC) based on immune checkpoint inhibitors, the AASLD has re-evaluated and updated the practice guidance. The update revises related texts and recommendations for adjuvant therapy and the management algorithms for HCC recurrence during or after adjuvant therapy. Furthermore, the AASLD emphasizes that even for HCC patients at a high risk of recurrence after resection or local ablation, close monitoring for recurrence remains the current standard treatment regimen. Our team makes an excerpt of the update, systematically introduces the background and specific contents of the update, and discuss the adjuvant therapy for HCC, in order to provide a reference for readers.
2.Interpretation of critical update:AASLD practice guidance on prevention,diagnosis,and treatment of hepatocellular carcinoma
Yuze ZHAO ; Yuxiao CHEN ; Kechun WANG ; Mingda WANG ; Tian YANG
Journal of Clinical Hepatology 2025;42(5):851-854
In February 2025,the American Association for the Study of Liver Diseases(AASLD)published online"Critical Update:AASLD Practice Guidance on Prevention,Diagnosis,and Treatment of Hepatocellular Carcinoma".This update mainly focuses on the latest analysis results of the IMbrave050 study and performs corresponding updates and adjustments to recommendations based on the issues in clinical practice.As for the postoperative adjuvant therapeutic strategies for hepatocellular carcinoma(HCC)based on immune checkpoint inhibitors,the AASLD has re-evaluated and updated the practice guidance.The update revises related texts and recommendations for adjuvant therapy and the management algorithms for HCC recurrence during or after adjuvant therapy.Furthermore,the AASLD emphasizes that even for HCC patients at a high risk of recurrence after resection or local ablation,close monitoring for recurrence remains the current standard treatment regimen.Our team makes an excerpt of the update,systematically introduces the background and specific contents of the update,and discuss the adjuvant therapy for HCC,in order to provide a reference for readers.
3.Application strategy of circulating tumor DNA in entire process of precision medicine for hepatocellular carcinoma
Mingda HE ; Yuze YANG ; Mingda WANG ; Chao LI ; Han WU ; Tian YANG
Chinese Journal of Digestive Surgery 2025;24(1):86-92
Hepatocellular carcinoma (HCC) remains a leading cause of cancer-related death worldwide, emphasizing the utmost importance of early diagnosis, therapeutic monitoring, and pro-gnostic assessment. Circulating tumor DNA (ctDNA), as an innovative liquid biopsy biomarker, has demonstrated unique advantages in HCC management. The authors systematically summarized recent advances in the application of ctDNA for early diagnosis, therapeutic monitoring, and prognostic evaluation of HCC, focusing on its advantages and clinical application value in precision medicine.
4.Progress in the update of 2024 European Association for the Study of the Liver clinical practice guidelines for management of hepatocellular carcinoma
Yuze YANG ; Mingda WANG ; Lanqing YAO ; Xinfei XU ; Ping ZHANG ; Feng SHEN ; Tian YANG
Chinese Journal of Digestive Surgery 2025;24(2):198-205
In December 2024, the European Association for the Study of the Liver (EASL) released the 2024 edition of EASL clinical practice guidelines: management of hepatocellular carci-noma (HCC). Compared to the 2018 edition, the 2024 edition includes significant updates in several areas, such as personalized surveillance strategies based on individual risk assessment, standardiza-tion of liver imaging protocols and diagnostic criteria, the use of minimally invasive surgical approaches in complex cases, an updated approach to liver transplantation integration, transitions between surgery, locoregional, and systemic therapies, as well as the positioning of radiotherapy and the use of combination immunotherapy at various stages of the disease. The authors systematically interpret the main updates related to treatment strategies in the new guidelines, aiming to provide clinicians with clear decision-making references for treatment.
5.Application strategy of circulating tumor DNA in entire process of precision medicine for hepatocellular carcinoma
Mingda HE ; Yuze YANG ; Mingda WANG ; Chao LI ; Han WU ; Tian YANG
Chinese Journal of Digestive Surgery 2025;24(1):86-92
Hepatocellular carcinoma (HCC) remains a leading cause of cancer-related death worldwide, emphasizing the utmost importance of early diagnosis, therapeutic monitoring, and pro-gnostic assessment. Circulating tumor DNA (ctDNA), as an innovative liquid biopsy biomarker, has demonstrated unique advantages in HCC management. The authors systematically summarized recent advances in the application of ctDNA for early diagnosis, therapeutic monitoring, and prognostic evaluation of HCC, focusing on its advantages and clinical application value in precision medicine.
6.Progress in the update of 2024 European Association for the Study of the Liver clinical practice guidelines for management of hepatocellular carcinoma
Yuze YANG ; Mingda WANG ; Lanqing YAO ; Xinfei XU ; Ping ZHANG ; Feng SHEN ; Tian YANG
Chinese Journal of Digestive Surgery 2025;24(2):198-205
In December 2024, the European Association for the Study of the Liver (EASL) released the 2024 edition of EASL clinical practice guidelines: management of hepatocellular carci-noma (HCC). Compared to the 2018 edition, the 2024 edition includes significant updates in several areas, such as personalized surveillance strategies based on individual risk assessment, standardiza-tion of liver imaging protocols and diagnostic criteria, the use of minimally invasive surgical approaches in complex cases, an updated approach to liver transplantation integration, transitions between surgery, locoregional, and systemic therapies, as well as the positioning of radiotherapy and the use of combination immunotherapy at various stages of the disease. The authors systematically interpret the main updates related to treatment strategies in the new guidelines, aiming to provide clinicians with clear decision-making references for treatment.
7.Systemic therapy for advanced hepatocellular carcinoma
Jiahao XU ; Dongxu YIN ; Yuchen LI ; Fujie CHEN ; Mingda WANG ; Tian YANG
Journal of Clinical Hepatology 2024;40(11):2306-2314
Hepatocellular carcinoma(HCC)is one of the most common malignancies with high morbidity and mortality rates worldwide.With the advances in molecular biology and tumor immunology,molecular-targeted agents represented by tyrosine kinase inhibitors(such as sorafenib and lenvatinib)and immunotherapy represented by PD-1/PD-L1 monoclonal antibodies have brought hope for patients with advanced HCC.The combination of immunotherapy and anti-angiogenic therapy can further improve the treatment outcome of patients.In addition,the optimization and integration of stereotactic body radiotherapy,local treatment,and systemic treatment may maximize the benefits of patients.In the future,through a deep understanding of the heterogeneity of HCC,the development of precision molecular subtyping and individualized treatment,and the establishment of a multidisciplinary collaborative diagnosis and treatment system,systemic therapy is expected to achieve long-term management of advanced HCC.This article reviews the current status and advances in systemic therapy for advanced HCC.
8.Interpretation of clinical practice guidelines of diagnosis and treatment of hepatobiliary tumors: hepatocellular carcinoma and intrahepatic cholangiocarcinoma
Mingliang SHI ; Yang SHEN ; Mingda WANG ; Tian YANG
Chinese Journal of Digestive Surgery 2024;23(2):188-196
Primary liver cancer is a highly malignant tumor of the digestive tract, charac-terized by an insidious onset and frequently accompanied by local progression or distant metastasis. Although surgical resection is typically the optimal treatment for patients with locally resectable tumors, the major challenge in achieving long-term survival prognosis lies in the high postoperative recurrence rate. Due to the substantial heterogeneity and complexity of primary liver cancer, a multimodal comprehensive treatment approach involving surgical resection, systemic therapy ( e.g., targeted therapy, chemotherapy, immunotherapy), and/or local treatment is commonly employed. As research regarding primary liver cancer continues to progress, it becomes crucial for surgical oncologists to acquire a deep understanding and proficiency in the latest surgical diagnostic and treatment methods, along with optimal patient selection and management strategies. The authors aim to comprehensively elaborate on the latest practice guidelines for surgically treatment of primary liver cancer and systematically outline the key points in evaluating primary liver cancer, primarily focusing on hepatocellular carcinoma and intrahepatic bile duct carcinoma, and offer pertinent recommendations for clinical treatment, thus providing robust evidence in the clinical management and decision-making for patients with primary liver cancer.
9.Recommendations from Annals of Surgical Oncology: Clinical guidelines for extrahepatic cholangiocarcinoma and gallbladder carcinoma
Wei GUO ; Xin LI ; Mingda WANG ; Tian YANG
Journal of Clinical Hepatology 2024;40(4):682-687
Biliary tract carcinoma (BTC) is a type of gastrointestinal tumor with a low incidence rate and a strong invasive ability, mainly including intrahepatic cholangiocarcinoma (ICC), extrahepatic cholangiocarcinoma (ECC), and gallbladder carcinoma (GC), often accompanied by local progression or distant metastasis. Surgery is often the preferred treatment method for patients with local resectable tumor; however, there is still a high risk of recurrence after radical surgery. Therefore, multiple treatment modalities are often required for BTC patients, including surgical resection, systemic treatment (such as targeted therapy, chemotherapy, and immunotherapy), and/or a combination of local treatment methods. With the development of the field of BTC, it is critical for surgical oncologists to understand and master the latest surgical strategies and the best patient selection and management systems. In view of the complexity of treatment and the continuous development of diagnosis and treatment techniques, Annals of Surgical Oncology, an authoritative American journal of cancer surgery, recently published the practical diagnosis and treatment guidelines for hepatobiliary tumors, including hepatocellular carcinoma (HCC), ICC, ECC, and GC, aiming to provide more evidence-based evidence for the clinical management and decision-making of patients with hepatobiliary tumors. Due to the limitations of length and different emphases, this article mainly introduces the recommendations for the evaluation points and clinical treatment of ECC and GC in the guidelines, so as to provide a reference for clinical practice.
10.Advances in the application of microspheres and nanoparticles in transcatheter arterial chemoembolization for the treatment of hepatocellular carcinoma
Chuyue ZHANG ; Jianing SHI ; Mingda WANG ; Han WU ; Lijun SHI ; Tian YANG
Journal of Clinical Hepatology 2024;40(4):816-821
In recent years, transcatheter arterial chemoembolization (TACE) has emerged as a common treatment modality for the treatment of hepatocellular carcinoma (HCC). However, with the ongoing development of embolic agent techniques, the new advances in microspheres and nanoparticles have brought new hope for improving the efficacy and safety of TACE. This article reviews the latest advances and applications of microspheres and nanoparticles in TACE for HCC. First, this article introduces the background of TACE as a therapeutic approach and the emergence of microsphere and nanoparticle techniques, and then it describes the application of various types of microspheres and nanoparticles in TACE and discusses the requisite attributes of an ideal embolic agents. The article focuses on the advances in material science and engineering, as well as the clinical efficacy of drug-eluting microspheres and nanoparticles versus conventional TACE. Furthermore, it discusses the importance of radiological examination in TACE and summarizes the research advances in the radiopaque and magnetic resonance-visible embolic agents. This article also explores the future development directions and challenges of TACE. It also points out the combination of microspheres and nanoparticles with other treatment modalities, the application of personalized and precision medicine in TACE, and the potential regimen of TACE in clinical translation, and meanwhile, it raises the issues of ethics and regulation that need to be further discussed. It is believed that microspheres and nanoparticles have a potential effect in TACE, which provides a theoretical basis and technical support for innovating HCC treatment regimens and improving the prognosis of patients through TACE interventions.

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