On August 6, the paper titled “Management of patients with hepatocellular carcinoma and portal vein tumor thrombosis: comparing east and west” composed by several top experts from China and U. S. together in the field of liver cancer was published in “The Lancet Gastroenterology & Hepatopathy” in the form of cover paper. Among others, Prof. Teng Gaojun, Director of Zhongda Hospital Affiliated to Southeast University and Prof. Cheng Shuqun from Shanghai Eastern Hepatobiliary Surgery Hospital are the correspondent authors.
Liver cancer is one of the worst malignant tumors after treatment with more than 700,000 new cases foundworldwide each year, about half of which occur in China. The formation of portal vein tumor thrombus (PVTT) is deemed as an important marker for advanced liver cancer, with the natural survival lasting for only 2.7 to 4 months. The treatment of PVTT has become a worldwide medical problem. Due to differences in etiology, medical policies, doctors' tendencies, and new drugs and new devices adopted forpatients suffering from liver cancer in the oriental and western countries, the treatment system of liver cancer still features significant differences in Asian countries, Europe and the United States. The most influential Barcelona clinical liver cancer guidelines (referred to as “BCLC guidelines”) in the treatment of liver cancer with PVTT only provide targeted drugs, but the effect of existing targeted drugs is unsatisfactory.
In the past over decade, Asian countries and regions represented by China have adopted a series of innovative treatments such as surgery, interventional therapy, radiation therapy and systemic therapy, etc.for liver cancer with PVTT. Remarkable curative effects have been achieved in terms of the treatment of liver cancer with PVTT and thus a treatment system different from that in western countries has been gradually formed. Nevertheless, the current international clinical guidelines have not yet adopted these new technologies and new ideas from the East.
Professor Teng Gaojun pointed out that the review has comprehensively analyzed and compared the diagnosis and treatment strategies in the East and West in respect of diagnosis, classification, surgery, radiotherapy, interventional embolization, stent opening and systemic treatment of liver cancer with PVTT. In addition, the review has further listed the differences in etiology, medical policy, doctor's tendency and new drugs and new devices adopted for treating liver cancer in the East and West; meanwhile, it’s also analyzed the causes of such differences in depth. This article pointed out the shortcomings of the current internationally authoritative BCLC treatment strategy for treating liver cancer with PVTT, and made some supplementations. Besides, it demonstrated the research achievements made in the East, especially by Chinese scholars, which would be conducive to promote the multi-regional and multidisciplinary exchanges and cooperation in the worldwide area, and break through the bottleneck of treating liver cancer with PVTTwith joint efforts (Lu Jian, Cheng Shouqin).