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Improving the Conversion Success Rate of Hepatocellular Carcinoma: Focus on the Use of Combination Therapy with a High Objective Response Rate

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Journal of Clinical and Translational Hepatology 2024年第3期12卷 298-304页

作者： Qi-Feng chen Song chen minshan chen Ning Lyu Ming Zhao Department of Minimally Invasive Interventional Therapy Liver Cancer Study and Service GroupSun Yat-sen University Cancer CenterGuangzhouGuangdongChina State Key Laboratory of Oncology in South China GuangzhouGuangdongChina Department of Liver Surgery Sun Yat-sen University Cancer CenterGuangzhouGuangdongChina

The high mortality rate in hepatocellular carcinoma(HCC)is partially due to the fact that a significant number of patients are diagnosed at an intermediate or advanced stage,with surgical treatment options *** therapy,which involves both locoregional and systemic treatments,has the potential to downstage tumors in selected patients with initially unresectable HCC,thereby making surgical treatment a possibility and potentially increasing long-term *** optimize the conversion rate,it is necessary to maximize successful conversions and clearly define the target population for conversion treatment through a collaborative *** this review article,we summarize the clinical experience and evidence for conversion therapy in patients with‘potentially resectable’HCC from four perspectives:1)defining the target population for conversion therapy,2)selecting the appropriate conversion strategy,placing emphasis on the utilization of combination therapy that exhibits a significant objective response rate,3)determining the timing and urgency of surgical resection,4)promoting the adoption of a multidisciplinary team *** authors are optimistic that with the continuous progress in treatment and a deeper understanding of HCC,the success rate of HCC conversion therapy will increase,and the overall survival of HCC patients will be prolonged.

关键词： Hepatocellular carcinoma Conversion therapy Conversion rate Targeted population Combination therapy

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Three-dimensional bioprinted liver tissue for transplantation: hope or hype?

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Hepatobiliary Surgery and Nutrition 2020年第6期9卷 788-790页

作者： Feihu Xie Yao Xiao minshan chen Department of Hepatobiliary Surgery Sun Yat-sen University Cancer CenterGuangzhouChina Peking Union Medical College BeijingChina

Liver transplantation is one of the best available choices for those with end-stage liver diseases and liver cancer who meet Milan criteria(1,2).However,a critical shortage of available liver donors is the main problem associated with transplantation,which presumably cannot be solved in the foreseeable *** effects have been made in the last few decades to compensate for this shortage,including developing different kinds of artificial liver support systems(3).Unfortunately,it is still far away from meeting the demand.

关键词： liver diseases Liver

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The beneficial effects of intermittent fasting:an update on mechanism,and the role of circadian rhythm and gut microbiota

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Hepatobiliary Surgery and Nutrition 2020年第5期9卷 597-602页

作者： Dandan Hu Zhibo Xie Yuqian Ye Suhad Bahijri minshan chen Department of Liver Surgery Sun Yat-Sen University Cancer CenterGuangzhouChina Department of Surgery Peking Union Medical College HospitalBeijingChina Department of Clinical Biochemistry Faculty of MedicineKing Abdulaziz UniversityJeddahSaudi Arabia Saudi Diabetes Study Research Group(SDRG)-King Fahd Medical Research Centre King Abdulaziz UniversityJeddahSaudi Arabia

Importance:There is accumulating evidence that intermittent fasting(IF)is connected to improved health condition and longevity time-restricted feeding(TRF)is the most recognized and extensively studied model of ***:To investigate the underlying mechanism of pleiotropic benefits of IF and hint the most advantageous feeding pattern for *** review:We searched MEDLINE,EMBASE,Cochrane Library and Google Scholar by 2020 April for publications on IF or TRF and their *** include animal models and human ***:One important mechanism is that IF allows certain period of fasting time,in which our bodies activate pathways of repair and ***,the advantages of IF,especially TRF over total caloric restriction(CR)provided bases for various animal and human studies which suggested that the feeding-fasting rhythm stimulates the fluctuation of our gut microbiota and a series of subsequent molecular alterations,which in turn restored a healthier circadian clock that resembled our inherent clock formed throughout millions of years of homo sapiens *** and Relevance for Reviews:Complete understanding of the mechanism leading to the beneficial effects of IF paves the way for tailored dietary regimen to combat a wide range of diseases and ill health conditions.

关键词： Intermittent fasting(IF) circadian rhythm gut microbiota

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Transcatheter arterial chemoembolization combined with simultaneous cone beam computed tomography-guided multipolar microwave ablation for massive hepatocellular carcinoma(≥10 cm):Safety and primary clinical results

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Journal of Interventional Medicine 2019年第2期2卷 65-68页

作者： Xiongying Jiang Xue Han Tianqi Zhang Zhimei Huang Jingxian Shen Yajun Bo Guiqun chen minshan chen Jinhua Huang Department of Minimally Invasive Interventional Radiology Sun Yat-sen University Cancer Center651 Dongfeng East RoadGuangzhouPR China State Key Laboratory of Oncology in South China Collaborative Innovation Center for Cancer MedicinePR China Department of Interventional Radiology Sun Yat-sen University Memorial HospitalSun Yat-sen UniversityYanjiang West RoadGuangzhouPR China Department of Imaging Sun Yat-sen University Cancer Center651 Dongfeng East RoadGuangzhouPR China Department of Oncology Kaiyuan People's HospitalHonghe Hani&Yi Autonomous PrefectureYunnan ProvincePR China Department of Hepatobiliary&Pancreatic Surgery Sun Yat-sen University Cancer Center651 Dongfeng East RoadGuangzhouPR China

Purpose:To explore the safety and clinical efficacy of transcatheter arterial chemoembolization(TACE)combined with simultaneous cone beam computed tomography(CBCT)-guided multipolar microwave ablation(MWA)in the treatment of massive hepatocellular carcinoma(HCC).Materials and methods:Records of nine patients who underwent TACE combined with simultaneous CBCT-guided multipolar MWA for massive HCC,between January and June 2015,were retrospectively *** success rate,blood levels of liver function indicators,complications,and tumor response one month after treatmentwere ***:The technical success rate of TACE combined with simultaneous MWA was 100%.The mean procedure time was 195.0 min(range,125-350 min),the mean hospital stay after the treatment was 4.0±1.0 days(range,3-7 days),and no serious complications *** complications were experienced by some patients but were relieved after conservative *** month after treatment,enhanced CT revealed a complete response rate of 66.7%(6/9),a partial response rate of 22.2%(2/9),and a stable disease rate of 11.1%(1/9).Mild and reversible injury of liver function occurred in these ***:TACE combined with simultaneous CBCT-guided MWA for massive HCC was feasible and safe,and yielded a high response rate.

关键词： Cone beam CT Simultaneous Microwave ablation Massive hepatocellular carcinoma

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对胆管癌的定义、分类和中文命名的思考和建议

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中华外科杂志 2022年第4期60卷 351-355页

作者：陈敏山中山大学肿瘤防治中心肝脏外科广州510060

目前关于胆管癌的分类、命名和定义在国内外均存在较多争议,给临床工作的使用带来了混乱。此工作需要根据肿瘤命名原则、解剖部位、肿瘤起源、病理分类、生物学特征、临床表现、治疗方式等;还需要遵循:WHO肿瘤分类、UICC分期、ICD疾病... 详细信息

目前关于胆管癌的分类、命名和定义在国内外均存在较多争议,给临床工作的使用带来了混乱。此工作需要根据肿瘤命名原则、解剖部位、肿瘤起源、病理分类、生物学特征、临床表现、治疗方式等;还需要遵循:WHO肿瘤分类、UICC分期、ICD疾病分类、中国相关规范;并参考欧洲肝病学会指南、AJCC分期、NCCN指南。作者针对所存在的问题,结合我国临床实际,对胆管癌的定义、分类和中文命名进行思考,并提出更新建议,希望能够规范和统一临床实际工作中胆管癌的分类和中文命名。

关键词：胆管癌定义分类命名法

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42,573 cases of hepatectomy in China： a multicenter retrospective investigation

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Science China(Life Sciences) 2018年第6期61卷 660-670页

作者： Binhao Zhang Bixiang Zhang Zhiwei Zhang Zhiyong Huang Yifa chen minshan chen Ping Bie Baogang Peng Liqun Wu Zhiming Wang Bo Li Jia Fan Lunxiu Qin Ping chen Jingfeng Liu Zhe Tang Jun Niu Xinmin Yin Deyu Li Songqing He Bin Jiang Yilei Mao Weiping Zhou Xiaoping chen Institute of Hepato-pancreato-bililary Surgery Tongji Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan 430030 China Eastern Hepatobiliary Surgery Hospital Shanghai 201805 China Union Hospital Beijing 100032 China Cancer Hospital of Sun Yat-sen University Guangzhou 510060 China Southwest Hospital Chongqing 400038 China The First Affiliated Hospital of Sun Yat-sen University Guangzhou 510080 China Affiliated Hospital of Qingdao Medical College Qingdao 266071 China Xiangya Hospital Changsha 410008 China West China Hospital Chengdu 610041 China Zhongshan Hospital of Fudan University Shanghai 200032 China Huashan Hospital of Fudan University Shanghai 100044. China Daping Hospttal the Third Military Medical University Chongqing 400042 China Mengchao Hepatobiliary Hospital Fuzhou 350025 China The First Affiliated Hospital of Zhengzhou University Zhengzhou 450052 China Qilu Hospital of Shandong University Jinan 250012 China Hunan People's Hospital Changsha 410002 China Henan People's Hospital Zhengzhou 450003 China The First Affiliated Hospital of Guangxi Medical University Nanning 530021 China Taihe Hospital Shiyan 442000 China

Hepatectomy is currently routinely performed in most hospitals in China. China owns the largest population of liver diseases and the biggest number of liver resection cases. A nationwide multicenter retrospective investigation involving 112 hospitals was performed, and focused on liver resection for patients with hepatocellular carcinoma(HCC). 42,573 cases of hepatectomy were enrolled, and 18,275 valid cases of liver resection for HCC patients were selected for statistical analysis. The epidemiology of HCC, distribution of hepatectomy, postoperative complications and prognosis were finally analyzed. In the 18,275 HCC patients,81% had hepatitis B virus infection and 10% had hepatitis C virus infection. 38% of the HCC patients had normal Alphafetoprotein(AFP) level, and other 35% had an AFP level lower than 400 ng mL^(-1). In the study period, 97% of the hepatectomy for HCC were treated with open surgery, and 23.81% had vascular exclusion techniques. The operation time was(191.7±105.6) min,the blood loss was(546.0±562.8) m L, and blood transfusion was(543.0±1,035.2) m L. The median survival for HCC patients was 631 days, with 1-, 3-, and 5-year overall survival of 73.2%, 28.8% and 19.6%, respectively. Liver cirrhosis, multiple nodules,tumor thrombosis and high AFP level were risk factors that affect postoperative survival.

关键词： hepatectomy hepatocellular carcinoma China

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Chinese expert consensus on clinical application of molecularly targeted drugs for hepatocellular carcinoma (2022 edition)

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中华医学杂志(英文版) 2024年第21期137卷 2630-2632页

作者： Sun Juxian Li Qiu Bai Xueli Cai Jianqiang chen Yajin chen minshan Dai Chaoliu Fang Chihua Jia Weidong Li Xiangcheng Wen Tianfu Xia Jinglin Ying Mingang Zhang Zhiwei Zhang Xuewen Zeng Zhaochong cheng Shuqun Department of Hepatic Surgery VI Eastern Hepatobiliary Surgery Hospital Naval Medical University Shanghai China Department of Medical Oncology Cancer Center West China Hospital Sichuan University Chengdu Sichuan China Department of Hepatobiliary and Pancreatic Surgery The First Affiliated Hospital Zhejiang University School of Medicine Hangzhou Zhejiang China Department of Hepatobiliary Surgery Cancer Hospital Chinese Academy of Medical Sciences Beijing China Department of Hepatobiliopancreatic Surgery Sun Yat-Sen Memorial Hospital Sun Yat-Sen University Guangzhou Guangdong China Department of Hepatobiliary Surgery Sun Yat-sen University Cancer Center Guangzhou Guangdong China Department of Hepatobiliary and Spleenary Surgery The Affiliated Shengjing Hospital China Medical University Shenyang Liaoning China Department of Hepatobiliary Surgery Zhujiang Hospital First Military Medical University Guangzhou Guangdong China Department of General Surgery Anhui Key Laboratory of Hepatopancreatobiliary Surgery Anhui Provincial Hospital The First Affiliated Hospital of USTC University of Science and Technology of China Hefei Anhui China Hepatobiliary Center The First Affiliated Hospital of Nanjing Medical University Key Laboratory of Living Donor Liver Transplantation Nanjing Jiangsu China Department of Liver Surgery West China Hospital of Sichuan University Chengdu Sichuan China The First Affiliated Hospital of Wenzhou Medical University Wenzhou Zhejiang China Liver Cancer Institute & Zhongshan Hospital Fudan University Shanghai China Department of Gastrointestinal Oncological Surgery Fujian Provincial Cancer Hospital Fujian Medical University Teaching Hospital Fuzhou Fujian China Department of Surgery Hepatic Surgery Center Institute of HBP Surgery Tongji Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan Hubei China Department of Hepatobiliary and Pancreas Surgery The Second Hospital of Jilin University Changc

Primary liver cancer is one of the most common malignant tumors in China. In 2020, 410,038 new cases of liver cancer and 391,152 deaths due to liver cancer were reported in China, which places liver cancer as the second most common cancer-related cause of death in China; of these cancers, hepatocellular carcinoma(HCC) accounts for 85-90%. HCC poses a significant threat to the lives and health of Chinese people.

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肝动脉灌注化疗在肝癌转化治疗中的研究进展

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中华消化外科杂志 2021年第2期20卷 171-177页

作者：陈敏山胡自力中山大学肿瘤防治中心肝脏外科广州510060

原发性肝癌是目前我国第4位常见恶性肿瘤及第2位肿瘤致死病因,严重威胁我国人民的生命和健康。原发性肝癌中>90%病人是肝细胞癌(以下简称肝癌),其中66%的病人初诊时已处于中晚期,失去手术机会。因此,中晚期肝癌的防治及转化治疗尤为重... 详细信息

原发性肝癌是目前我国第4位常见恶性肿瘤及第2位肿瘤致死病因,严重威胁我国人民的生命和健康。原发性肝癌中>90%病人是肝细胞癌(以下简称肝癌),其中66%的病人初诊时已处于中晚期,失去手术机会。因此,中晚期肝癌的防治及转化治疗尤为重要。肝动脉灌注化疗(HAIC)是中晚期肝癌的重要治疗手段,以其为核心的转化治疗展现出较好的肿瘤反应率及手术转化率。笔者深入分析国内外HAIC相关研究进展,系统阐述其发展历史及以HAIC为核心的转化治疗。

关键词：肝肿瘤肝动脉灌注化疗 FOLFOX 转化治疗联合治疗

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肝癌复发转移的多学科治疗策略

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中华肝脏病杂志 2016年第5期24卷 327-329页

作者：陈健聪陈敏山中山大学肿瘤防治中心肝胆科广州510060

随着早期诊断技术和外科治疗技术的提高，肝癌患者术后疗效不断提高，但其远期疗效仍不理想。对于复发的肿瘤，治疗方法应包括再次手术治疗、局部治疗及系统治疗等多学科治疗手段，多学科治疗是提高复发肝癌总体疗效的关键措施，它可以... 详细信息

随着早期诊断技术和外科治疗技术的提高，肝癌患者术后疗效不断提高，但其远期疗效仍不理想。对于复发的肿瘤，治疗方法应包括再次手术治疗、局部治疗及系统治疗等多学科治疗手段，多学科治疗是提高复发肝癌总体疗效的关键措施，它可以根据病情实际，合理运用不同的学科治疗手段并联合应用，发挥各种治疗方法的优势，以便达到最好的治疗效果。

关键词：癌肝细胞肿瘤转移复发多学科治疗策略

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血管介入治疗在肝癌转化治疗领域的研究进展

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中华消化外科杂志 2022年第2期21卷 210-216页

作者：陈敏山潘扬勋中山大学肿瘤防治中心肝脏外科广州510060

原发性肝癌是目前我国第4位常见恶性肿瘤及第2位肿瘤致死病因, 严重威胁我国人民的生命和健康。原发性肝癌中>90%的患者病理学类型是肝细胞癌(以下简称肝癌), 其中约60%的患者初次确诊时已处于中晚期, 失去根治性手术机会。因此, 通过... 详细信息

原发性肝癌是目前我国第4位常见恶性肿瘤及第2位肿瘤致死病因, 严重威胁我国人民的生命和健康。原发性肝癌中>90%的患者病理学类型是肝细胞癌(以下简称肝癌), 其中约60%的患者初次确诊时已处于中晚期, 失去根治性手术机会。因此, 通过转化治疗提高此类患者的手术切除率, 达到根治从而延长患者生存时间尤为重要。以经导管动脉化疗栓塞术和肝动脉灌注化疗为代表的血管介入治疗是中晚期肝癌患者的重要治疗手段, 展示出较好的肿瘤反应率和手术转化率。笔者结合国内外研究资料, 深入分析血管介入治疗在肝癌转化治疗领域的研究进展, 系统阐述其发展衍变过程及以其为核心的转化治疗策略。

关键词：肝肿瘤血管介入治疗肝动脉栓塞化疗肝动脉灌注化疗 FOLFOX 转化治疗联合治疗

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