小肝癌的规范化治疗路径

当前，手术切除仍是小肝癌治疗的首选，是获得长期生存的重要途径。射频和微波消融等技术的进步，小肝癌治疗由单一手术治疗过渡到手术与非手术治疗并存。消融治疗和手术切除者的存活率无显著差异，但手术切除无瘤生存及复发率则更具优势。肝移植不仅去除肿瘤,同时也解决了小肝癌多中心起源的问题，与肝切除相比，小肝癌肝移植后存活率稍高，复发率稍低。尽管如此，小肝癌的转移复发率仍居高不下，癌细胞本身、肿瘤微环境和肝病背景均发挥着不容忽视的作用。因此，肝癌的早期发现和早期诊断、遵循基于循证医学的规范化治疗路径，以及肿瘤生物学基础研究的临床转化，是实现小肝癌疗效再次飞跃的保证。

Medical approach to treatments of small liver cancer

Currently,surgical resection remains the prior treatment choice for small hepatocellular carcinoma(HCC) ,and long term survival is predictable in those received hepatectomy. The advent and technical progression in radiofrequency and microwave ablation provide alternative choices for small HCC. Although local ablative therapies have yield similar overall survival rates to that of surgical resection,surgical resection is superior to local ablative therapies in terms of recurrence rate and tumor-free survival....