Reflection on Stage-guided Treatment Algorithm of Hepatocellular Carcinoma
14:20-14:40 Room 101 (101講堂)
A reflection on stage-guided treatment algorithm of hepatocellular carcinoma
Stage-guided treatment algorithms such as BCLC system were conceptualized in an era when effective systemic therapy was not available. In such guidelines, surgery and other locoregional therapies tend to be conservative and are recommended only for those patients with lower risk of recurrence. The recent development of efficacious systemic treatment may change the outlook. For example, contemporary adjuvant clinical trials allow patients with higher risks of recurrence to be resected or ablated, then followed by adjuvant systemic therapy.
Efficacious systemic therapy may down-stage or ”alter-biology” of the tumors, and thereby render the unresectable resectable. Specifically, immunotherapy may invoke a durable immune equilibrium status in the residual tumors, resection or ablation of these residual tumors may prove clinically beneficial.
With the rapid development of efficacious systemic therapy, the stringent treatment recommendation for individual stages of HCC may become less relevant. A multimodality team to heed all stages of disease and all periods of clinical course is becoming more and more important.