Surgical treatment of liver malignant tumors with extrahepatic metastasis / 中华消化外科杂志

ABSTRACT

With the development of diagnostic and screening technologies,the incidence of hepatocellular carcinoma (HCC) with extrahepatic metastasis is increasing and surgical rate is also increasing.There is currently no standard of treatment.Four famous experts and their teams in hepatic surgery discussed reasonability of surgical treatment for HCC with extrahepatic metastasis based on clinical experiences.Professor Geng Xiaoping suggested that HCC with extrahepatic metastasis was classified as advanced HCC,however,under the premise of strict control of indications,selective patients undergoing comprehensive treatment combined with surgical procedures could achieve good prognosis.For some rare liver malignancies,active surgical treatment for extrahepatic metastasis based on comprehensive treatment was recommended.Professor Zhou Jian proposed that resection of intrahepatic lesions in HCC with extrahepatic metastasis should be based on the premise of whether to prolong the survival of patients.He advocated choice of individualized treatment and comprehensive treatment of multiple methods to benefit patients' survival.The necessary intrahepatic lesion resection was a positive and feasible treatment strategy.Professor Wang Jie shared the diagnosis and treatment of 2 patients with HCC and extrahepatic metastasis,suggested that primary tumor resection might have a favorable impact on the prognosis of these patients with resectable primary tumors.Therefore,surgical treatment was important for HCC patients with extrahepatic metastasis,and surgical therapy combined with personalized systemic treatment showed survival benefit for selected patients.Professor Zhou Weiping recommended that choosing surgery for HCC with extrahepatic metastasis should be extraordinarily cautious.Priority should be given to improving the survival rate of patients.In the case of effective control or complete necrosis of extrahepatic metastases,hepatic primary tumor resection was still the current mainstream opinion.