晚期肝细胞癌免疫靶向联合转化序贯外科治疗专家共识(2024版)

Expert consensus on the sequential surgery following conversion therapy based on the combination of immune checkpoint inhibitors and antiangiogenic targeted drugs for advanced hepatocellular carcinoma(2024 edition)

多达半数的肝细胞癌患者初诊时即为晚期,而对于晚期肝细胞癌尚缺乏有效的根治性治疗措施,患者预后较差。近年来,免疫检查点抑制剂联合抗血管生成靶向药物治疗晚期肝细胞癌已显示出较高的有效率,显著延长了患者的生存期,也为序贯外科根治性手术提供了可能。经转化治疗后序贯根治性肝切除或肝移植治疗,可使患者获得长期生存获益。为了提高肝癌总体人群的远期生存率,实现《"健康中国2030"规划纲要》恶性肿瘤总体5年生存率提高15%的目标,中华预防医学会肝胆胰疾病预防与控制专业委员会、中国抗癌协会肝癌专业委员会、北京医学会外科学分会肝脏学组组织国内相关专业专家,就《基于免疫联合靶向方案的晚期肝细胞癌转化治疗中国专家共识(2021版)》发布以来新的进展进行了深入的讨论,并就相关要点的修改、增补达成新的共识,以进一步指导临床实践,规范医疗行为,推动学科发展。

Up to half of patients with hepatocellular carcinoma(HCC)in China are diagnosed at an advanced stage and often with a dismal prognosis.More effective treatment strategies are mandatory.In recent years,the combination of immune checkpoint inhibitors and anti-angiogenic targeted therapy has shown a promising treatment effect in advanced HCC with prolonged survival of patients,which also offered an opportunity for sequential curative surgery.Sequential curative hepatectomy or liver transplantation following conversion therapy brings survival benefits to patients.Aiming to improve the long-term survival of overall population with liver cancer and contribute to the goal of a 15%increase in the 5-year survival of overall cancer patients outlined in the"Healthy China 2030"blueprints,the Professional Committee for Prevention and Control of Hepatobiliary and Pancreatic Diseases of Chinese Preventive Medicine Association,Chinese Society of Liver Cancer,and the Liver Study Group of Surgery Committee of Beijing Medical Association organized in-depth discussions among relevant domestic experts.These discussions focus on the latest progress since the release of Chinese expert consensus on conversion therapy of immune checkpoint inhibitors combined antiangiogenic targeted drugs for advanced hepatocellular carcinoma(2021 edition)and have reached new consensus on the modifications and supplements to some key points.This consensus aims to further guide clinical practice,standardize medical protocol,and usher the new development in liver surgery.