JOURNAL OF CLINICAL SURGERY ›› 2025, Vol. 33 ›› Issue (10): 1043-1047.doi: 10.3969/j.issn.1005-6483.20250942

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Update of clinical decision-making of upfront resection versus subsequent resection after neoadjuvant or conversion therapies among patients with hepatocellular carcinoma

WU Lu,ZHANG Xianghua,XIA Yong,SHEN Feng   

  1. Department of Hepatobiliary Surgery 4,the third hospital affiliated to Naval Medical University,China
  • Received:2025-09-24 Online:2025-11-11 Published:2025-11-11

Abstract: In recent years, clinical decision-making system has been developed and refined by incorporating patient's characteristics,tumor markers,clinlabomics and radiomics and has served a complementary role with classic hepatocellular carcinoma clinical staging systems among therapeutic choices of hepatocellular carcinoma during past decade.With the promotion of liver cancer screening programs, increasing patients with very early or early-stage hepatocellular carcinoma may attain upfront cure by partial liver resection,transplantation or local ablation.Advanced hepatocellular carcinoma with vascular invasion has been identified as inappropriate candidates of upfront curative therapies among several cohorts and clinical practice consensus.A heterogenous proportion of intermediate stage hepatocellular carcinomas have been reported to attain upfront cure with usually short recurrence-free survival (RFS) among several prospective cohorts.An unneglectable of patients with advanced stage hepatocellular carcinomas has been reported to subsequent curative resection after downstaging by conversion therapies.Subsequent resection after neoadjuvant therapies have improved the RFS and overall survival of patients with intermediate hepatocellular carcinoma.

Key words: liver neoplasm, therapeutic option, clinical decision-making, prognostic prediction

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