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Advices proposed by Professor Lyu Yi and colleagues are accepted by Guidelines for Diagnosis and Treatment of Primary Liver Cancer in China (2017 Edition)

Updated: Dec 13, 2019
From: Department of Hepatobiliary Surgery, Clinical Research Center
Edited by: Liu Huiting
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Primary liver cancer is one of the most common malignant tumors in China, ranking 3rd in terms of mortality rate among cancer-related death. A total of 55% of patients with primary liver cancer are Chinese. At present, Barcelona Clinic Liver Cancer Staging, which is commonly adopted worldwide, has been challenged and questioned by Asian countries including China due to the excessively strict definition of surgical treatment of primary liver cancer. According to the special situation that HBV infection is the main cause of liver cancer in China, National Health Commission (formerly the Ministry of Health) first introduced the Guidelines for Diagnosis and Treatment of Primary Liver Cancer in China (2011 Edition) for Chinese population and updated the original edition in 2017 to guide the diagnosis and treatment of liver cancer in China.

The English version of Guidelines for Diagnosis and Treatment of Primary Liver Cancer in China (2017 Edition), written byFan Jia, Academician of Chinese Academy of Sciences from Fudan University, Dong Jiahong, Academician of Chinese Academy of Sciences from Tsinghua University and other experts, was published in Liver Cancer in 2018. During the diagnosis and treatment of primary liver cancer, the team led by Professor Lyu Yi identified one piece of the guidelines for stage IV patients (those complicated with end-stage liver diseases, Child-Pugh class C) is questionable. In the guidelines, only symptomatic supportive treatment and palliative treatment are recommended for stage IV patients. However, in clinical practice, liver transplantation is indicated for primary liver cancer patients with Child-Pugh class C liver function if the tumor load meets certain criteria. Therefore, Professor Zhang Xufeng wrote a letter to the Editorial Board of Liver Cancer and proposed that liver transplantation should be considered in the treatment of patients with stage IV liver cancer, which has been highly recognized by Academician Fan Jia and other experts.

From December 5 to 8, 2019, Guidelines for Diagnosis and Treatment of Primary Liver Cancer in China (2019 Edition) was formally established during the 17th National Liver Cancer Conference in conjunction with the 1st Shanghai International Liver Cancer Forum held in Shanghai.Professor Zhou Jian from Liver Cancer Institute of Fudan University interpreted the guidelines and delivered a report on Update of Guidelines for Diagnosis and Treatment of Primary Liver Cancer in China (2019 Edition). The guidelines confirm that liver transplantation can be considered for CNLC stage IV patients if the tumor load meets UCSF criteria.

Standards/guidelines for clinical diagnosis and treatment of certain diseases are formulated based on a large quantity of evidence-based medical researches by authoritative experts in this field, which plays a pivotal role in guiding clinical practice. However, the guidelines still need to be periodically updated and improved, and more studies are urgently required to validate the controversial scientific issues. In recent years, Department of Hepatobiliary Surgery in the First Affiliated Hospital of Xi’an Jiaotong University has established a distinctive sub-specialized ward covering all hepatobiliary and pancreatic disciplines including biliary tract ward, pancreatic ward, liver surgery and liver transplantation ward, liver ward, minimally invasive surgery and metabolic surgery ward and surgical ICU ward,etc. III Department of Hepatobiliary Surgery is the liver surgery and liver transplantation ward. Currently, surgeons can perform all types of liver surgeries, such as laparoscopic/open complicated liver cancer resection,ex vivoliver resection, liver transplantation and pediatric living donor liver transplantation. Unremitting efforts have been delivered to make breakthroughs and innovations regarding liver surgery technology and concepts. Department of Hepatobiliary Surgery has been devoted to both the translation of basic studies and clinical research. In recent years, it has made breakthroughs in clinical research, aiming to guide clinical practice. With the support of Key Project of Clinical Research Center of our hospital, an international multi-center study on pancreatic neuroendocrine tumors led by the team of Professor Lyu Yi and Professor Zhang Xufeng from our hospital was online published in July 2019 inA nnals of Surgery (IF: 9.476), which is the most authoritative journal in the field of surgery. This study will also provide important basis for the revision and improvement of the new pNETs TNM staging. Department of Hepatobiliary Surgery will make unremitting efforts and continually contribute to the development of clinical research in our hospital.

Letter link:https://www.karger.com/Article/FullText/497459

Guidelines for Diagnosis and Treatment of Primary Liver Cancer in China (2017 Edition)link:https://www.karger.com/Article/FullText/488035

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