Multimodality Treatments for Large and Giant Liver Cancers
摘要
In China, liver cancer has two notable features: more than 80% of the patients with liver cancer have varying degrees of cirrhosis; the tumors of 80% of the patients have already grown large and are in the intermediate to advanced stage at the time of the hospital visit. Traditionally, liver cancers are categorized into large and small liver cancers, with a maximum tumor diameter of 5 cm as the boundary. However, with the increase in surgical cases and the accumulation of experience, this classification method is far from meeting the clinical needs. Therefore, Xiaoping Chen et al. proposed in 1994 that liver cancers can be divided into the following classes according to the tumor size: micro-liver cancer (maximum tumor diameter ≤2.0 cm); small liver cancer (2.0 cm 10.0 cm). Hepatectomy is the preferred treatment option for micro and small liver cancer if the patient’s condition permits. However, the overwhelming majority of liver cancer patients present with intermediate to advanced-stage disease with large or giant liver cancer during the hospital visit, and 80% of patients have liver cirrhosis. The mortality and morbidity of postoperative complications of surgical resection are relatively high in these patients, and therefore, many physicians do not recommend surgical treatment. But, in clinical practice, a good few patients with giant liver cancer treated by surgical resection do obtain long-term survival. If surgery is quickly abandoned, these patients will lose the opportunity to achieve long-term survival.