ReviewHepatobiliary surgery and nutrition2026
Chinese expert consensus on conversion and perioperative therapy of primary liver cancer (2024 edition).
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- From local control to immune synergy: the evolving role of stereotactic body radiotherapy in the immunotherapy era of hepatocellular carcinoma.Hepatobiliary surgery and nutrition · 2026Article
- From disease to syndrome pattern: a study on the differentiation of traditional Chinese medicine syndrome patterns in asthma using multi-omics characterization.Frontiers in immunology · 2026Article
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116 authors.
Zheng Wang *Department of Hepatobiliary Surgery and Liver Transplantation, Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, China.
Huichuan Sun *Department of Hepatobiliary Surgery and Liver Transplantation, Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, China.
Jian ZhouDepartment of Hepatobiliary Surgery and Liver Transplantation, Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, China.
Qing XieDepartment of Infectious Disease, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Xinyu BiDepartment of Hepatobiliary Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Xiufeng LiuDepartment of Medical Oncology of PLA Cancer Center, Jinling Hospital, Nanjing, China.
Rong LiuDepartment of Interventional Therapy, Zhongshan Hospital, Fudan University, Shanghai, China.
Ming ZhaoMinimally Invasive Interventional Division, Sun Yat-sen University Cancer Center, Guangzhou, China.
Xueli BaiDepartment of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
Yuan JiDepartment of Pathology, Fudan University Shanghai Cancer Centre, Shanghai, China.
Li XuDepartment of Liver Surgery, Sun Yat-sen University Cancer Centre, Guangzhou, China.
Weidong JiaDepartment of Liver Surgery, The First Affiliated Hospital of USTC, Hefei, China.
Shaochong ZengDepartment of Radiotherapy, Zhongshan Hospital, Fudan University, Shanghai, China.
Gong LiDepartment of Radiation Oncology, Beijing Tsinghua Changgung Hospital, Beijing, China.
Wei ZhangDepartment of Hepatobiliary Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin's Clinical Research Center for Cancer, Tianjin, China.
Shunli ShenDepartment of Hepatic Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
Shengxiang RaoDepartment of Radiology, Zhongshan Hospital, Fudan University, Shanghai, China.
Guoming ShiDepartment of Hepatobiliary Surgery and Liver Transplantation, Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, China.
Lan ZhangDepartment of Hepatic Oncology, Zhongshan Hospital, Fudan University, Shanghai, China.
Xiaodong ZhuDepartment of Hepatobiliary Surgery and Liver Transplantation, Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, China.
Zhifeng WuDepartment of Radiotherapy, Zhongshan Hospital, Fudan University, Shanghai, China.
Jiabei WangDepartment of Hepatobiliary Surgery, Anhui Province Key Laboratory of Hepatopancreatobiliary Surgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China.
Haowen TangDepartment of Hepatobiliary Surgery, First Medical Center of Chinese People's Liberation Army (PLA) General Hospital, Beijing, China.
Dousheng BaiDepartment of Hepatobiliary Surgery, Clinical Medical College, Yangzhou University, Yangzhou, China.
Yajin ChenDepartment of Hepatobiliopancreatic Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.
Yongjun ChenDivision of Hepatobiliary Surgery, Department of General Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
Chaoliu DaiDepartment of Hepatobiliary and Splenic Surgery, Shengjing Hospital Affiliated to China Medical University, Shenyang, China.
Fangming GuDepartment of Hepatobiliary surgery, Third Affiliated Hospital of Naval Medical University, Shanghai, China.
Jinhe GuoCenter of Interventional Radiology and Vascular Surgery, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing, China.
Rongping GuoThe Department of Hepatobiliary Oncology of Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.
Wenzhi GuoDepartment of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Feng HanDepartment of Hepatobiliary Surgery, Henan Cancer Hospital, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, China.
Guohong HanDepartment of Gastroenterology, Digestive Hospital, Xi'an International Medical Center Hospital, Xi'an, China.
Chunyi HaoKey Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Sarcoma Center, Peking University Cancer Hospital and Institute, Beijing, China.
Tao HuangDepartment of Hepatobiliary Surgery, Affiliated Tumour Hospital of Zhengzhou University, Zhengzhou, China.
Xiaolun HuangDepartment of Liver Transplantation Center and HBP Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
Yangqing HuangDepartment of General Surgery, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Zhiyong HuangDepartment of Liver Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Shunchang JiaoDepartment of Medical Oncology, First Medical Center of Chinese People's Liberation Army (PLA) General Hospital, Beijing, China.
Deyu LiDepartment of Hepato-Biliary Pancreatic Surgery, Henan Provincial People's Hospital, Zhengzhou, China.
Tao LiDepartment of General Surgery, Qilu Hospital, Shandong University, Jinan, China.
Xiangcheng LiDepartment of Liver Transplantation Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
Guangming LiCenter of General Surgery, Beijing YouAn Hospital, Capital Medical University, Beijing, China.
Ping LiangDepartment of Interventional Ultrasound, First Medical Center of Chinese People's Liberation Army (PLA) General Hospital, Beijing, China.
Xiao LiangDepartment of General Surgery, Zhejiang University, School of Medicine, Sir Run-Run Shaw Hospital, Hangzhou, China.
Jinguan LinDay Chemotherapy Center, Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China.
Fubao LiuDivision of General Surgery, First Affiliated Hospital, Anhui Medical University, Hefei, China.
Jiwei LiuDepartment of Oncology, First Affiliated Hospital of Dalian Medical University, Dalian, China.
Jingfeng LiuDepartment of Hepatopancreatobiliary Surgery, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, China.
Zheng LuDepartment of Hepatobiliary Surgery, The First Affiliated Hospital of Bengbu Medical College, Bengbu, China.
Weifu LvDepartment of Interventional Radiology, the First Affiliated Hospital of USTC (Anhui Provincial Hospital), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China.
Yilei MaoDepartment of Liver Surgery, Peking Union Medical College (PUMC) Hospital, PUMC & Chinese Academy of Medical Sciences (CAMS), Beijing, China.
Zhiqiang MengDepartment of Integrated Traditional Chinese and Western Medicine, Shanghai Cancer Center, Fudan University, Shanghai, China.
Chuang PengDepartment of Hepatobiliary Surgery, Hepatobiliary Hospital, Hunan Provincial People's Hospital, Changsha, China.
Li PengDepartment of Hepatobiliary Surgery, The Fourth Hospital of Hebei Medical University, Hebei Tumor Hospital, Shijiazhuang, China.
Tao PengDepartment of Hepatobiliary Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, China.
Ming ShiDepartment of Liver Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China.
Yinghong ShiDepartment of Hepatobiliary Surgery and Liver Transplantation, Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, China.
Tianqiang SongDepartment of Hepatobiliary Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin's Clinical Research Center for Cancer, Tianjin, China.
Guang TanDepartment of Hepatobiliary Surgery, First Affiliated Hospital of Dalian Medical University, Dalian, China.
Yunqiang TangDepartment of Hepatic-Biliary Surgery, The Affiliated Cancer Hospital of Guangzhou Medical University, Guangzhou, China.
Kaishan TaoDepartment of Hepatobiliary Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, China.
Chidan WanDepartment of Hepatobiliary Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Guangyi WangDepartment of Hepatobiliary and Pancreatic Surgery, The First Hospital of Jilin University, Changchun, China.
Kui WangDepartment of Hepatobiliary surgery, Third Affiliated Hospital of Naval Medical University, Shanghai, China.
Lu WangLiver Surgery Department, Shanghai Cancer Center, Fudan University, Shanghai, China.
Maoqiang WangDepartment of Interventional Radiology, First Medical Center of Chinese People's Liberation Army (PLA) General Hospital, Beijing, China.
Shunxiang WangDepartment of Hepatobiliary Surgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China.
Wentao WangDepartment of Liver Surgery, West China School of Medicine, West China Hospital of Sichuan University, Chengdu, China.
Tianfu WenDepartment of Liver Surgery & Liver Transplantation Centre, West China Hospital of Sichuan University, Chengdu, China.
Bangde XiangHepatobiliary Surgery Department, Guangxi Liver Cancer Diagnosis and Treatment Engineering and Technology Research Center, Key Laboratory for High-Incidence Tumor Prevention and Treatment, Ministry of Education, Guangxi Medical University Cancer Hospital, Nanning, China.
Baocai XingHepatopancreatobiliary Surgery Department I, Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education, Peking University School of Oncology, Beijing Cancer Hospital and Institute, Beijing, China.
Jianming XuDepartment of Medical Oncology, First Medical Center of Chinese People's Liberation Army (PLA) General Hospital, Beijing, China.
Jun XuDepartment of Hepatobiliary and Pancreatic Surgery and Liver Transplant Center, The First Hospital of Shanxi Medical University, Taiyuan, China.
Sheng YanDivision of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
Dinghua YangUnit of Hepatobiliary Surgery, Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China.
Jiayin YangDepartment of Liver Surgery, West China School of Medicine, West China Hospital of Sichuan University, Chengdu, China.
Guowen YinDepartment of Intervention, Cancer Hospital of Jiangsu, Nanjing, China.
Zhengping YuDepartment of Hepatobiliary Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
Yongyi ZengDepartment of Hepatobiliary Pancreatic Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China.
Jialin ZhangDepartment of Hepatobiliary Surgery, the First Hospital of China Medical University, Shenyang, China.
Shuijun ZhangKey Laboratory of Hepatobiliary and Pancreatic Surgery and Digestive Organ Transplantation of Henan Province, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Ti ZhangDepartment of Hepatic Surgery, Fudan University Shanghai Cancer Center, Shanghai Medical College, Fudan University, Shanghai, China.
Yamin ZhangDepartment of Hepatobiliary Surgery, Tianjin First Central Hospital, Tianjin, China.
Yu ZhangHepatobiliary & Pancreatic Center, Sichuan Academy of Medical Sciences, Sichuan Provincial People's Hospital, Chengdu, China.
Yubao ZhangDepartment of Hepatobiliary Pancreatic Surgery, Harbin Medical University Cancer Hospital, Harbin, China.
Zhiwei ZhangDepartment of Liver Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Aibin ZhangDepartment of Hepatobiliary Pancreatic Surgery, The First Affiliated Hospital of College of Medicine, Zhejiang University, Hangzhou, China.
Haitao ZhaoDepartment of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Hong ZhaoDepartment of Hepatobiliary Surgery, Cancer Hospital Chinese Academy of Medical Sciences, Beijing, China.
Ledu ZhouDepartment of Liver Surgery, Xiangya Hospital, Central South University, Changsha, China.
Weiping ZhouDepartment of Hepatobiliary surgery, Third Affiliated Hospital of Naval Medical University, Shanghai, China.
Zhenyu ZhuHepatoliliary Surgery Center, 302 Hospital of PLA, Beijing, China.
Shukui QinGastrointestinal Cancer Center of Nanjing Tianyinshan Hospital, China Pharmaceutical University, Nanjing, China.
Feng ShenDepartment of Hepatic Surgery IV, the Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China.
Xiujun CaiDepartment of General Surgery, Sir Run-Run Shaw Hospital, Zhejiang University, Hangzhou, China.
Jianqiang CaiDepartment of Hepatobiliary Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Minshan ChenDepartment of Liver Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China.
Qiang LiDepartment of Hepatobiliary Surgery, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China.
Lianxin LiuDepartment of Hepatobiliary Surgery, State Key Laboratory of Immune Response and Immunotherapy, Center for Leading Medicine and Advanced Technologies of IHM, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China.
Weilin WangDepartment of Hepatobiliary and Pancreatic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Tingbo LiangDepartment of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
Bixiang ZhangDepartment of Liver Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Shichun LuDepartment of Hepatobiliary Surgery, First Medical Center of Chinese People's Liberation Army (PLA) General Hospital, Beijing, China.
Shuqun ChengDepartment of Hepatobiliary surgery, Third Affiliated Hospital of Naval Medical University, Shanghai, China.
Zhenggang RenDepartment of Hepatic Oncology, Zhongshan Hospital, Fudan University, Shanghai, China.
Hong WuDepartment of Liver Surgery, West China School of Medicine, West China Hospital of Sichuan University, Chengdu, China.
Ming KuangDepartment of Hepatic Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
Gaojun TengCenter of Interventional Radiology and Vascular Surgery, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing, China.
Kefeng DouDepartment of Hepatobiliary, pancreatic and splenic surgery, Xijing Hospital, Air Force Military Medical University, Xi'an, China.
Jiahong DongHepatopancreatobiliary Center, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Changping, Beijing, China.
Xiaoping ChenDepartment of Liver Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Xuehao WangHepatobiliary Center, The First Affiliated Hospital of Nanjing Medical University, Key Laboratory of Liver Transplantation, Chinese Academy of Medical Sciences, NHC Key Laboratory of Living Donor Liver Transplantation (Nanjing Medical University), Nanjing, China.
Shusen ZhengDivision of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The First Affiliated Hospital, Zhejiang University, School of Medicine, Hangzhou, China.
Jia FanDepartment of Hepatobiliary Surgery and Liver Transplantation, Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, China.
Alliance of Liver Cancer Conversion Therapy, Liver Cancer Committee, China Anti-Cancer Association
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: A significant portion of primary liver cancer patients in China are diagnosed at intermediate-to-advanced stages, often making them ineligible for curative surgery. Furthermore, high postoperative recurrence rates, reaching up to 70%, pose a major challenge for long-term survival. The emergence of novel systemic treatments, such as immune checkpoint inhibitor combinations, and advancements in locoregional therapies have created new opportunities for conversion and perioperative strategies. This updated consensus aims to standardize the clinical application of these therapies based on the latest evidence, with the objective of improving patient prognosis. Methods: A multidisciplinary committee of 97 experts was convened to revise previous guidelines. The process involved a comprehensive search of medical databases and conference proceedings, with evidence graded according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. Consensus statements were finalized through a formal electronic voting process, requiring at least 80% agreement for approval, resulting in 18 updated statements. Results: The consensus provides refined definitions for conversion and perioperative therapy. It recommends various strategies for oncological conversion, including systemic therapy with anti-angiogenic drugs plus immunotherapy, and locoregional approaches like precision transarterial chemoembolization (TACE) and hepatic artery infusion chemotherapy (HAIC). The document strongly affirms surgical resection as a crucial step for achieving long-term survival after successful conversion and offers guidance on surgical timing and adjuvant therapy. For resectable patients with high-risk features, neoadjuvant and adjuvant treatments are outlined to mitigate recurrence. The consensus also advocates for using dynamic enhanced magnetic resonance imaging (MRI) and the modified Response Evaluation Criteria in Solid Tumors (mRECIST) criteria for efficacy assessment and underscores the essential role of a multidisciplinary team in management. Conclusions: This updated consensus offers standardized, evidence-based guidance for clinicians on implementing conversion and perioperative strategies to optimize patient-centered care and highlights the need for continued research to further refine these promising approaches.
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Chinaconsensusconversion therapyLiver neoplasmsperioperative therapy
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