Surgery is still the first choice for patients with hepatocellular carcinoma(HCC).However,about 70%of HCC patients in China are first diagnosed in the advanced stage and have lost the opportunity for surgery.Recently,the rapid development of systematic therapy has brought new hope for patients with advanced HCC.The combination of molecular targeted therapy and immunotherapy with or without local therapy significantly improves the survival of advanced HCC and alters the landscape of surgical treatment in advanced HCC.In addition,systemic therapy also brings new opportunities for perioperative treatment of HCC patients.Conversion therapy,neoadjuvant therapy,and postoperative adjuvant therapy can increase the chances of surgical treatment,reduce the risk of postoperative metastasis and recurrence,and prolong the overall survival of HCC patients.Systematic therapy based on molecular targeted therapy and immunotherapy has been applied through the whole process of HCC surgical treatment,and has completely altered the surgery paradigm of HCC.However,further research is needed to determine the optimal combination protocol,screen the sensitive populations,address drug resistance,and reduce systemic adverse events.

Cancer is one of the leading causes responsible for resident's death worldwide.The abnormal status of cancer metabolism and metabolic target antitumor therapy are becoming the hotpot in cancer research.Shortly after the close of 2017 American Society of Clinical Oncology (ASCO) annual meeting,the progress in the field of cancer metabolism and nutrition support could be reviewed in four aspects:clinical investigation of drugs targeting metabolic pathway,metabolism based radiological technologies,role and mechanism of metabolic molecules involved in tumor initiation and progress,and clinical nutrition support.

Precision oncology is applying established clinic-pathological indexes with molecular profiling to create diagnostic,prognostic,and therapeutic strategies precisely tailor to each patient's requirements.It includes precision prevention (cancer risk detection and prophylactic intervention),precision diagnosis (early detection and diagnosis,molecular classification),and precision treatment (molecular targeted therapies,predicting and monitoring treatment response and precision surgery based on the combination of visual,cytology,pathologic review,as well as molecular profiling assessments).Understanding of cancer and clinical decision making from the molecular level is necessary in era of precision oncology.Many challenges,including the heterogeneity and dynamic evolution of cancer cells,few understanding about cancer biology,pairing the massive genomic data with inaccurate clinical information,limited sensitive drugs and unexplained resistance,insufficient cancer biomarkers for precision diagnosis and treatment,have to be overcome before it can be clinical routines.