Zhang XD, Zhang LY, Luo JL, Yu KH, Zhu KL. Neoadjuvant therapy: Dawn of reducing the high post-surgery recurrence rate of hepatocellular carcinoma. World J Gastrointest Surg 2025; 17(3): 103740 [DOI: 10.4240/wjgs.v17.i3.103740]
Corresponding Author of This Article
Ke-Lei Zhu, Chief Physician, MD, PhD, Department of Hepatopancreatobiliary Surgery, The Affiliated People's Hospital of Ningbo University, No. 251 Baizhang East Road, Ningbo 315040, Zhejiang Province, China. dr.zkl@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Xiao-Dong Zhang, Jia-Liang Luo, Ke-Heng Yu, Ke-Lei Zhu, Department of Hepatopancreatobiliary Surgery, The Affiliated People's Hospital of Ningbo University, Ningbo 315040, Zhejiang Province, China
Lu-Yi Zhang, Zhejiang Provincial Key Laboratory of Pathophysiology, Health Science Center, Ningbo University, Ningbo 315211, Zhejiang Province, China
Author contributions: Zhang XD performed the majority of the writing, performed data accusation; Zhang LY prepared the figures and tables; Luo JL and Yu KH provided the input in writing the paper; Zhu KL designed the outline and coordinated the writing of the paper.
Supported by the Zhejiang Provincial Medical and Health Science and Technology Plan, No. 2022ZH050; and the Health Science and Technology Project of Yinzhou District, No. 2023Y03.
Conflict-of-interest statement: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as potential conflicts of interest.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ke-Lei Zhu, Chief Physician, MD, PhD, Department of Hepatopancreatobiliary Surgery, The Affiliated People's Hospital of Ningbo University, No. 251 Baizhang East Road, Ningbo 315040, Zhejiang Province, China. dr.zkl@163.com
Received: December 3, 2024 Revised: January 1, 2025 Accepted: January 14, 2025 Published online: March 27, 2025 Processing time: 87 Days and 0.2 Hours
Abstract
The high postoperative recurrence rate remains a major challenge in the treatment of hepatocellular carcinoma (HCC) following resection. Increasing research has been delved into investigating the role of neoadjuvant therapy on the prognosis of resectable HCC. Recent trends in combination therapy with molecularly targeted agents and immune checkpoint inhibitors have significantly improved the efficacy of systemic antitumor treatments, yielding survival benefits exceeding 40%. Neoadjuvant therapy for HCC, whether based on systemic antitumor treatments, locoregional therapies, or their combination, has emerged as a promising research direction. However, there remains a matter of debate on neoadjuvant therapy. In this review, we summarize and discuss the research progress and challenges of neoadjuvant therapy for HCC over the past five years from the perspective of Chinese guidelines to provide new insights and future directions in this field.
Core Tip: Currently, numerous articles focus on preoperative antitumor therapy for hepatocellular carcinoma (HCC). Of note, this review uniquely examines neoadjuvant therapy for HCC within the context of combination therapy from the perspective of the China Liver Cancer Stage. Drawing on the Chinese guidelines, it addresses the definition of the neoadjuvant therapy concept, identifies the target population, evaluates the outcomes of various treatment strategies, and discusses the challenges regarding neoadjuvant therapy for HCC.
