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Post-Surgical Recurrence of Hepatocellular Carcinoma

The Chinese-German Journal of Clinical Oncology 2002年第1期1卷 30-31页

作者： cheng hongyan department of radiology, eastern hepatobiliary surgery hospital, second military medical university, shanghai 200438, china department of radiology Eastem Hepatobiliary Surgery Hospital Second Military Medical University Shanghai China

Objective To analyze post-surgical recurrence of hepatocellular carcinoma (HHC) according to pathologic findings, primary tumor and angiographic features of the recurrent tumor.Methods In this series, 100 cases of recurrent HCC were analyzed in following aspects: ( 1) size, tumor nodular numbers, gross and histologic findings of the primary tumor; (2) post-surgical recurrent time; (3) size, tumor nodular numbers, blood supply, staining property, and accumulation of lipiodol oil in the recurrent tumor. Following angiography, arterial chemoembolization was performed. Results In the primary tumor, single nodules were seen in 80 cases, multiple nodules in 16 cases and multiple fused nodules in 4 cases. All tumors were classified as: trabecular type, 65 cases; compact type, 12; sclerotic type, 2 cases; mixed type, 15 cases and cholangiocarcinoma type, 6 cases. 38 cases had incomplete or no capsule. Satellite tumor nodules were grossly identified during operation in 33 cases, but were proven microscopically in 66 cases. Tumor thrombi of portal vein was noted in 18 cases during oeration, but 85 cases in histopathological sections. The recurrent tumors were diagnosed post surgically within 6 months in 67 cases, 6-12 months in 15 cases and after 12 months in 18 cases respectively. On angiography, 67 % recurrent tumors was rich in blood supply and with abundant accumulation of lipiodol after embolization.Conclusion The post-surgical recurrence rate of the HCC patients with massive size, incomplete or no capsule, satellite tumor nodules and portal vein tumor thrombus was high. The patients shoud receive angiography in 1 ?2 months after surgery in order to detect early recurrence and, if confirmed, the patients may be treated by transcatheter arterial chemoembolization

关键词： hepatocellular carcinoma recurrence

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肝静脉流出道病变的磁共振肝脏加速容积采集成像诊断

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实用放射学杂志 2008年第1期24卷 48-51页

作者：王晓琰程红岩第二军医大学附属东方肝胆外科医院放射科第二军医大学附属东方肝胆外科医院放射科上海200438

目的评价肝脏加速容积采集(LAVA)用于诊断肝静脉流出道病变的价值。方法78例肝癌、布加综合征和肝移植术后随访的患者接受了LAVA检查,分析LAVA图像质量及其对各种肝静脉流出道病变和侧枝循环的显示情况。结果78例LAVA图像均无伪影,血管... 详细信息

目的评价肝脏加速容积采集(LAVA)用于诊断肝静脉流出道病变的价值。方法78例肝癌、布加综合征和肝移植术后随访的患者接受了LAVA检查,分析LAVA图像质量及其对各种肝静脉流出道病变和侧枝循环的显示情况。结果78例LAVA图像均无伪影,血管显示清楚,达到诊断要求。LAVA均清楚地显示了肝静脉和下腔静脉正常解剖和各种病变,对肝静脉流出道病变的部位、程度、原因和侧枝分布均显示较好。结论LAVA作为一种无创性检查方法,能够在显示病变的同时明确病灶与血管关系。

关键词：磁共振血管成像肝静脉下腔静脉

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阻断动脉血流治疗少血供恶性肝肿瘤的初步研究

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中国介入影像与治疗学 2004年第1期1卷 60-64页

作者：程红岩陈栋徐爱民第二军医大学东方肝胆外科医院影像诊疗科上海200438

目的　改进少血供肝癌的介入治疗方法。方法　研究组 (3 4例 )患者采用球囊导管暂时阻断肝动脉血流 ,再灌注碘油和化疗药物 ;对照组 (4 0例 )患者则采用常规TACE疗法。随访观察疗效、副反应和生存时间。结果　研究组和对照组总有效率分... 详细信息

目的　改进少血供肝癌的介入治疗方法。方法　研究组 (3 4例 )患者采用球囊导管暂时阻断肝动脉血流 ,再灌注碘油和化疗药物 ;对照组 (4 0例 )患者则采用常规TACE疗法。随访观察疗效、副反应和生存时间。结果　研究组和对照组总有效率分别为 82 %和 65 % ,两组相差非常显著 (χ2 =12 .5 ,P <0 .0 1)。结论　球囊导管暂时性阻断肿瘤动脉血流 ,TACE治疗肝脏少血供的恶性肿瘤 ,方法简单 ,疗效肯定。

关键词：肝肿瘤,治疗性癌化学栓塞,治疗性球囊导管

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永久性栓塞微粒在治疗大肝癌中的初步研究

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介入放射学杂志 2004年第6期13卷 527-529页

作者：程红岩上海第二军医大学东方肝胆外科医院影像诊疗科 200438

目的　研究在介入治疗大肝癌中使用PVA栓塞微粒的作用。方法　 73例大肝癌患者 ,肿瘤直径在 8.4～ 2 0 .4cm ,平均 12 .3cm。肝功能Child分级均为A级。在TACE治疗中除使用碘油和化疗药物外 ,还使用PVA栓塞微粒 ,71例为 10 0mg ,2 0 0mg... 详细信息

目的　研究在介入治疗大肝癌中使用PVA栓塞微粒的作用。方法　 73例大肝癌患者 ,肿瘤直径在 8.4～ 2 0 .4cm ,平均 12 .3cm。肝功能Child分级均为A级。在TACE治疗中除使用碘油和化疗药物外 ,还使用PVA栓塞微粒 ,71例为 10 0mg ,2 0 0mg和 5 0mg各 1例。观察术前和术后肝功能的变化和肿瘤缩小程度。结果　肿瘤缩小程度 :平均缩小 3cm(P <0 .0 0 1) ;对肝功能影响 :术后总胆红素、直接胆红素、丙氨酸转氨酶和碱性磷酸酶均有不同程度的升高 ,血清白蛋白和白球蛋白比不同程度降低 (P <0 .0 0 1)。在 73例患者中 ,存活 31例 ,死亡 4 2例。结论　在大肝癌介入治疗中 ,辅助使用PVA栓塞微粒后疗效肯定 ,肿瘤有明显缩小 ,同时可避免永久性栓塞主要肿瘤血管 ,以利于再次的介入治疗 ;但治疗后可造成一定程度的肝功能损害 ,应注意剂量和保护肝功能。

关键词：栓塞大肝癌肿瘤介入治疗肝功能微粒患者术后治疗后治疗中

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肝癌门静脉癌栓内碘油沉积的CT表现和意义

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实用放射学杂志 2003年第7期19卷 627-630页

作者：程红岩徐爱民陈栋贾雨辰第二军医大学东方肝胆外科医院影像科第二军医大学东方肝胆外科医院影像科上海200438

目的　研究经皮肝动脉碘油化疗栓塞 (lipiodoltranscatheterarterialchemoembolization ,Lp -TACE)治疗肝癌后门静脉癌栓碘油沉积CT表现和意义。方法　 42例肝癌患者行Lp -TACE ,灌注碘油 5～ 2 0ml不等 ,碘油用量以肿瘤内基本上被碘油... 详细信息

目的　研究经皮肝动脉碘油化疗栓塞 (lipiodoltranscatheterarterialchemoembolization ,Lp -TACE)治疗肝癌后门静脉癌栓碘油沉积CT表现和意义。方法　 42例肝癌患者行Lp -TACE ,灌注碘油 5～ 2 0ml不等 ,碘油用量以肿瘤内基本上被碘油完全充满为止。经螺旋CT 3期薄层扫描发现门静脉内碘油沉积。结果　在 42例患者中巨块型肝癌 3 4例、多结节性 8例 (包括术后复发 4例 ) ;3 6例为多血供 ,6例少血供 ;DSA时 3 1例有动静脉瘘 ,11例无明显动静脉瘘 ;碘油沉积于门静脉右支 18例、左支 9例和左右支及主干 15例 ,6例随着Lp -TACE的次数增加 ,门静脉癌栓内碘油量也增加 ;门静脉内碘油表现为条片状 16例 ,混合状 10例 ,团状和“双轨”状各 6例 ,点状 4例。结论　Lp -TACE可使碘油进入门静脉 ,碘油沉积于门静脉癌栓内呈现不同的表现 ,并可起到一定的治疗作用。

关键词：癌,肝细胞化学栓塞,治疗性碘油栓子门静脉

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多层螺旋CT:三期薄层扫描发现微小肝癌病灶

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医学影像学杂志 2003年第4期13卷 251-254页

作者：程红岩徐爱民陈栋贾雨辰上海第二军医大学东方肝胆外科医院放射科上海200438

目的 :研究多层螺旋CT肝脏三期扫描 (Triple phasehelicalCT ,THCT)在发现微小肝癌病灶的作用 ,提高检出率 ,避免不必要的手术切除而导致的术后复发。方法 :选择原诊断为单发性肝癌并可手术者 2 0 0例 ,前瞻性薄层THCT ,即平扫、动脉期 ... 详细信息

目的 :研究多层螺旋CT肝脏三期扫描 (Triple phasehelicalCT ,THCT)在发现微小肝癌病灶的作用 ,提高检出率 ,避免不必要的手术切除而导致的术后复发。方法 :选择原诊断为单发性肝癌并可手术者 2 0 0例 ,前瞻性薄层THCT ,即平扫、动脉期 (2 4～ 2 5s)、门静脉期 (45～ 5 0s)和延迟期 (2～ 3min) ,对比剂为非离子型 (1.5ml/kg) ,注射速率为 3ml/s。发现5 4例患者 (2 7% ,5 4 / 2 0 0 )在主病灶周围或肝内有多发的微小病灶 (<10mm)。CT图像在PACS的网络工作站上 ,采用Rad worksTM5 .1版本软件 ,由 3名放射科医师分别在各自的工作站上观察分析。在CT检查后数天 ,行TACE(transcatherarterialchemoembolization ,TACE)。结果 :在 5 4例病例中 ,共发现微小病灶 2 70枚 ,平均 5枚。CT特点是平扫呈等密度或低密度 ,增强扫描动脉期呈等密度或高密度 ;门静脉期表现为高密度、等密度或低密度 ;延迟期呈等密度或低密度。敏感性分别为 :动脉期 91.85 % ,门静脉期 85 .5 6 %和延迟期 88.89% ,综合三期扫描敏感性为 93.33%。DSA上发现微小病灶的敏感性为 80 .74 %。结论 :薄层THCT扫描对发现肝内微小病灶是必须的 ,显示微小病灶以动脉期和延迟期为佳。

关键词：多层螺旋CT 三期薄层扫描微小肝癌病灶

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Alpha-fetoprotein,protein induced by vitamin K absence or antagonist-Ⅱ,lens culinaris agglutinin-reactive fraction of alpha-fetoprotein alone and in combination for early detection of hepatocellular carcinoma from nonalcoholic fatty liver disease:A multicenter analysis

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hepatobiliary & Pancreatic Diseases International 2022年第6期21卷 559-568页

作者： Ming-cheng Guan Wei Ouyang Si-Yu Liu Li-Yang Sun Wei-Yue Chen Xiang-Min Tong Hong Zhu Tian Yang department of medical Oncology the First Affiliated Hospital of Soochow UniversitySuzhou 215006China department of Laboratory Zhejiang University Lishui HospitalLishui 323000China department of hepatobiliary Pancreatic and Minimal Invasive SurgeryZhejiang Provincial People’s HospitalPeople’s Hospital of Hangzhou Medical CollegeHangzhou 310014China The Key Laboratory of Imaging Diagnosis and Minimally Invasive Interventional Research of Zhejiang Province Department of Interventional RadiologyZhejiang University Lishui HospitalLishui 323000China School of Clinical Medicine Hangzhou Medical CollegeHangzhou 310059China department of hepatobiliary surgery Eastern Hepatobiliary Surgery HospitalSecond Military Medical University(Navy Medical University)Shanghai 200438China

Background:Current surveillance strategies for hepatocellular carcinoma(HCC)among patients with non-alcoholic fatty liver disease(NAFLD)are *** study aimed to investigate the diagnostic perfor-mance of alpha-fetoprotein(AFP),protein induced by vitamin K absence or antagonist-Ⅱ(PIVKA-Ⅱ),lens culinaris agglutinin-reactive fraction of AFP(AFP-L3),and their combinations in HCC underlying NAFLD ***:Serologic AFP,AFP-L3,and PIVKA-Ⅱ levels in NAFLD patients with and without HCC were *** receiver operating characteristic(ROC)analyses,the area under the curve(AUC),sensitivity,and specificity were obtained to evaluate the diagnostic accuracy of each biomarker and their ***:This study was conducted on 139 patients with NAFLD-HCC and 345 NAFLD *** eleva-tion of these three biomarkers was observed in patients with NAFLD-HCC compared to those in NAFLD controls(all P<0.001).When they were analyzed individually,PIVKA-Ⅱ showed the best performance in diagnosing any-stage HCC with an AUC of 0.869,followed by AFP(0.763;***-Ⅱ,P<0.001)and AFP-L3(0.689;***-II,P<0.001).When they were analyzed in combination,AFP+PIVKA-Ⅱ yielded the highest AUC(0.906),followed by AFP+PIVKA-II+AFP-L3(0.904;***+PIVKA-Ⅱ,P=0.086),PIVKA-Ⅱ+AFP-L3(0.881;***+PIVKA-II,P<0.001),and AFP+AFP-L3(0.759;***+PIVKA-II,P<0.001).Similar findings were obtained in the subgroup with early-stage NAFLD-HCC,as well as the non-cirrhotic ***:These data validated the better diagnostic ability of PIVKA-II than AFP or AFP-L3 alone for diagnosing any-stage HCC among patients with NAFLD,and the combination of AFP+PIVKA-II signifi-cantly improved the diagnostic accuracy of NAFLD-HCC.

关键词： Hepatocellular carcinoma Nonalcoholic fatty liver disease Alpha-fetoprotein Lens culinaris agglutinin-reactive fraction of alpha-fetoprotein Protein induced by vitamin K absence or antagonist-Ⅱ

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Chemoprophylaxis, diagnosis, treatments, and discharge management of COVID-19: An evidence-based clinical practice guideline(updated version)

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military medical Research 2020年第3期7卷 249-282页

作者： Ying-Hui Jin Qing-Yuan Zhan Zhi-Yong Peng Xue-Qun Ren Xun-Tao Yin Lin Cai Yu-Feng Yuan Ji-Rong Yue Xiao-Chun Zhang Qi-Wen Yang Jianguang Ji Jian Xia Yi-Rong Li Fu-Xiang Zhou Ya-Dong Gao Zhui Yu Feng Xu Ming-Li Tu Li-Ming Tan Min Yang Fang Chen Xiao-Ju Zhang Mei Zeng Yu Zhu Xin-Can Liu Jian Yang Dong-Chi Zhao Yu-Feng Ding Ning Hou Fu-Bing Wang Hao Chen Yong-Gang Zhang Wei Li Wen Chen Yue-Xian Shi Xiu-Zhi Yang Xue-Jun Wang Yan-Jun Zhong Ming-Juan Zhao Bing-Hui Li Lin-Lu Ma Hao Zi Na Wang Yun-Yun Wang Shao-Fu Yu Lu-Yao Li Qiao Huang Hong Weng Xiang-Ying Ren Li-Sha Luo Man-Ru Fan Di Huang Hong-Yang Xue Lin-Xin Yu Jin-Ping Gao Tong Deng Xian-Tao Zeng Hong-Jun Li Zhen-Shun cheng Xiao-Mei Yao Xing-Huan Wang Center for Evidence-Based and Translational Medicine Zhongnan Hospital of Wuhan UniversityWuhan 430071China National Clinical Research Center for Respiratory Diseases China-Japan Friendship HospitalBeijing 100029China department of Pulmonary and Critical Care Medicine China-Japan Friendship HospitalBeijing 10029China Leishenshan hospital in Wuhan Wuhan 430200China department of Critical Care Medicine Zhongnan Hospital of Wuhan UniversityWuhan 430071China Institutes of Evidence-based Medicine and Knowledge Translation Henan UniversityKaifeng 475000HenanChina department of medical Imaging Guizhou Provincial People’s HospitalGuiyang 550002China departments of Orthopedics Zhongnan Hospital of Wuhan UniversityWuhan 430071China department of hepatobiliary surgery Zhongnan Hospital of Wuhan UniversityWuhan 430071China National Clinical Research Center for Geriatrics West China Hospital of Sichuan UniversityChengdu 610041China department of Geriatrics West China Hospital of Sichuan UniversityChengdu 610041China department of radiology Zhongnan Hospital of Wuhan UniversityWuhan 430071China department of Clinical Laboratory Peking Union Medical College Hospital(PUMCH)Peking Union Medical CollegeChinese Academy of Medical Sciences(CAMS)Beijing 100730China Center for Primary Health Care Research Lund University and Region Skåne25002 MalmöSweden Emergency Center Zhongnan Hospital of Wuhan UniversityWuhan 403371China department of Allergology Zhongnan Hospital of Wuhan UniversityWuhan 430071China department of Radiation and medical Oncology Zhongnan Hospital of Wuhan UniversityWuhan 43071China department of Critical Care Medicine Renmin Hospital of Wuhan UniversityWuhan 430060China department of Emergency Medicine and Chest Pain Center Qilu Hospital of Shandong UniversityJinan 250002China department of Respiratory and Critical Care Medicine Suizhou Central HospitalHubei University of MedicineSuizhou 441300HubeiChina department of Clinic Pharmacy Second People’s Hospital of Huaihua Ci

The novel severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)is the cause of a rapidly spreading illness,coronavirus disease 2019(COVID-19),affecting more than seventeen million people around the *** and treatment guidelines for clinicians caring for patients are *** the early stage,we have issued"A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus(2019-nCoV)infected pneumonia(standard version)";now there are many direct evidences emerged and may change some of previous recommendations and it is ripe for develop an evidence-based *** formed a working group of clinical experts and *** steering group members proposed 29 questions that are relevant to the management of COVID-19 covering the following areas:chemoprophylaxis,diagnosis,treatments,and discharge *** searched the literature for direct evidence on the management of COVID-19,and assessed its certainty generated recommendations using the Grading of Recommendations,Assessment,Development and Evaluation(GRADE)*** were either strong or weak,or in the form of ungraded consensus-based ***,we issued 34 *** them,6 were strong recommendations for,14 were weak recommendations for,3 were weak recommendations against and 11 were ungraded consensus-based *** covered topics of chemoprophylaxis(including agents and Traditional Chinese Medicine(TCM)agents),diagnosis(including clinical manifestations,reverse transcription-polymerase chain reaction(RT-PCR),respiratory tract specimens,IgM and IgG antibody tests,chest computed tomography,chest X-ray,and CT features of asymptomatic infections),treatments(including lopinavirritonavir,umifenovir,favipiravir,interferon,remdesivir,combination of antiviral drugs,hydroxychloroquine/chloroquine,interleukin-6 inhibitors,interleukin-1 inhibitors,glucocorticoid,qingfei paidu decoction,lianhua qingwen granules/capsules,convalescent plasma,lung

关键词： COVID-19 SARS-CoV-2 Recommendation Chemoprophylaxis Diagnosis Treatment Discharge management Traditional Chinese medicine guideline

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Association of tumor morphology with long-term prognosis after liver resection for patients with a solitary huge hepatocellular carcinoma-a multicenter propensity score matching analysis

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hepatobiliary surgery and Nutrition 2023年第3期12卷 314-327,I0006,I0007页

作者： Xin-Fei Xu Han Wu Ju-Dong Li Lan-Qing Yao Bin Huang Yong-Kang Diao Ting-Hao Chen Wei-Min Gu Zhong Chen Jie Li Yao-Ming Zhang Hong Wang Ying-Jian Liang Ya-Hao Zhou Chao Li Ming-Da Wang cheng-Wu Zhang Timothy MPawlik Wan Yee Lau Feng Shen Tian Yang department of hepatobiliary surgery Eastern Hepatobiliary Surgery HospitalNaval Medical University(Second Military Medical University)ShanghaiChina department of General surgery Changzheng HospitalNaval Medical University(Second Military Medical University)ShanghaiChina department of radiology Eastern Hepatobiliary Surgery HospitalNaval Medical University(Second Military Medical University)ShanghaiChina Division of hepatobiliary and Pancreatic surgery Department of General SurgeryCancer CenterZhejiang Provincial People’s HospitalPeople’s Hospital of Hangzhou Medical CollegeHangzhouChina department of General surgery Ziyang First People’s HospitalZiyangChina The First department of General surgery the Fourth Hospital of HarbinHarbinChina department of hepatobiliary surgery Affiliated Hospital of Nantong UniversityNantongChina department of hepatobiliary surgery Fuyang People’s HospitalFuyangChina The second department of hepatobiliary surgery Meizhou People’s HospitalMeizhouChina department of General surgery Liuyang People’s HospitalChangshaChina department of hepatobiliary surgery the First Affiliated Hospital of Harbin Medical UniversityHarbinChina department of hepatobiliary surgery Pu’er People’s HospitalPu’erChina department of surgery Ohio State UniversityWexner Medical CenterColumbusOHUSA Faculty of Medicine the Chinese University of Hong KongHong KongChina

Background:A solitary hepatocellular carcinoma(HCC)without macrovascular invasion and distant metastasis,regardless of tumor size,is currently classified as early-stage disease by the latest Barcelona Clinic Liver Cancer(BCLC)staging *** the preferred treatment is surgical resection,the association of tumor morphology with long-term survival outcomes after liver resection for a solitary huge HCC of≥10 cm has not been ***:Patients who underwent curative liver resection for a solitary huge HCC were identified from a multicenter *** imaging findings were used to define spherical-or ellipsoidal-shaped lesions with smooth edges as balloon-shaped HCCs(BS-HCCs);out-of-shape lesions or lesions of any shape with matt edges were defined as non-balloon-shaped HCCs(NBS-HCCs).The two groups of patients with BS-HCCs and NBS-HCCs were matched in a 1:1 ratio using propensity score matching(PSM).Clinicopathologic characteristics,long-term overall survival(OS)and recurrence-free survival(RFS)were ***:Among patients with a solitary huge HCC,74 pairs of patients with BS-HCC and NBS-HCC were *** pathological features including proportions of microvascular invasion,satellite nodules,and incomplete tumor encapsulation in the BS-HCC group were lower than the NBS-HCC *** a median follow-up of 50.7 months,median OS and RFS of all patients with a solitary huge HCC after PSM were 27.8 and 10.1 months,*** BS-HCC group had better median OS and RFS than the NBS-HCC group(31.9 vs.21.0 months,P=0.01;and 19.7 vs.6.4 months,P=0.015).Multivariate analyses identified BS-HCC as independently associated with better OS(HR=0.592,P=0.009)and RFS(HR=0.633,P=0.013).Conclusions:For a solitary huge HCC,preoperative imaging on tumor morphology was associated with prognosis following *** particular,patients with BS-HCCs had better long-term survival following liver resection versus patients with large NBS-HCCs.

关键词： Hepatocellular carcinoma(HCC) survival recurrence tumor morphology hepatectomy

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Multidisciplinary management of recurrent and metastatic hepatocellular carcinoma after resection: an international expert consensus

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hepatobiliary surgery and Nutrition 2018年第5期7卷 353-371页

作者： Tianfu Wen Chen Jin Antonio Facciorusso Matteo Donadon Ho-Seong Han Yilei Mao Chaoliu Dai Shuqun cheng Bixiang Zhang Baogang Peng Shunda Du Changjun Jia Feng Xu Jie Shi Juxian Sun Peng Zhu Satoshi Nara JMichael Millis Qiu Li Weixia Chen Wusheng Lu Hong Tang Lvnan Yan Yong Zeng Bo Li Jiayin Yang Wentao Wang Hong Wu Mingqing Xu Zheyu Chen Changli Lu Chuan Li Wei Peng Xiaoyun Zhang department of Liver surgery and Liver Transplantation Center West China HospitalSichuan UniversityChengdu 610041China department of medical and Surgical Sciences University of FoggiaFoggiaItaly department of hepatobiliary&General surgery Humanitas UniversityHumanitas Clinical and Research CenterMilanItaly Seoul National university Bundang hospital Seoul National University College of MedicineSeoulKorea department of Liver surgery Peking Union Medical College HospitalChinese Academy of Medical Sciences&Peking Union Medical CollegeBeijing 100730China department of hepatobiliary and Splenic surgery Shengjing HospitalChina Medical UniversityShenyang 110000China department of Hepatic surgery VI Eastern Hepatobiliary Surgery HospitalThe Second Military Medical UniversityShanghai 200433China Hepatic surgery Center Tongji HospitalHuazhong University of Science and TechnologyWuhan 430030China department of Liver surgery the First Affiliated Hospital of Sun Yat-sen UniversityGuangzhou 510080China hepatobiliary and Pancreatic surgery Division National Cancer Center HospitalTokyoJapan department of surgery University of ChicagoChicagoILUSA MDT of West china hospital department of medical Oncology Cancer CenterState Key Laboratory of BiotherapyWest China HospitalSichuan UniversityChengdu 610041China department of radiology West China HospitalSichuan UniversityChengdu 610041China Center of Infectious Diseases West China HospitalSichuan UniversityChengdu 610041China

Hepatocellular carcinoma (HCC) is the sixth-most common cancer and the third leading cause of cancer-related death in the world. However, 40–70% patients eventually suffer from postoperative recurrence within 5 years. HCC recurrence after surgery severely affects prognosis of the patients. Nevertheless, there is an opportunity to improve patients' prognosis if doctors and researchers can recognize the importance of a standardized perioperative management and study it in clinical and pre-clinical settings. Hence, based on our own experience and published studies from other researchers, we develop this consensus regarding multidisciplinary management of locally recurrent and metastatic hepatocellular carcinoma after resection. This consensus consists of the entire course of recurrent hepatocellular carcinoma (RHCC) management, including prediction of recurrence, prevention, diagnosis, treatment and surveillance of RHCC. Consensus recommendations are presented with grades of evidences (Ia, Ib, IIa, IIb, III and IV), and strength ofrecommendations (A, B, C, D and E). We also develop a decision-making path for RHCC treatment, which can intuitively demonstrate the management for RHCC. It is hoped that we may make some effort to standardize the management of RHCC and ultimately understand how to improve outcomes.

关键词： Recurrent hepatocellular carcinoma (RHCC) multidisciplinary management consensus

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