Meena BL, Sharma D. Are we overestimating success of salvage hepatectomy in unresectable hepatocellular carcinoma? World J Clin Oncol 2025; 16(9): 111537 [PMID: 41024834 DOI: 10.5306/wjco.v16.i9.111537]
Corresponding Author of This Article
Deepti Sharma, MD, Associate Professor, Department of Radiation Oncology, Institute of liver and Biliary Sciences, Vasant Kuunj, New Delhi 110070, India. drdeeptisharma16@gmail.com
Research Domain of This Article
Oncology
Article-Type of This Article
Letter to the Editor
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/
World J Clin Oncol. Sep 24, 2025; 16(9): 111537 Published online Sep 24, 2025. doi: 10.5306/wjco.v16.i9.111537
Are we overestimating success of salvage hepatectomy in unresectable hepatocellular carcinoma?
Babu Lal Meena, Deepti Sharma
Babu Lal Meena, Department of Hepatology, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India
Deepti Sharma, Department of Radiation Oncology, Institute of Liver and Biliary Sciences, New Delhi 110070, India
Co-first authors: Babu Lal Meena and Deepti Sharma.
Author contributions: Sharma D and Meena BL contributed to concept and design and writing of article and they are co-first authors. All authors approved the manuscript and its submission to the journal.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
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: Deepti Sharma, MD, Associate Professor, Department of Radiation Oncology, Institute of liver and Biliary Sciences, Vasant Kuunj, New Delhi 110070, India. drdeeptisharma16@gmail.com
Received: July 2, 2025 Revised: July 25, 2025 Accepted: August 20, 2025 Published online: September 24, 2025 Processing time: 83 Days and 11.8 Hours
Abstract
The Zhang et al’s study addresses an important clinical question of timing and role of salvage surgery post-downstaging procedures in patients with advanced hepatocellular carcinoma wherein different modalities like trans arterial chemoembolization, tyrosine kinase inhibitors, and anti-programmed cell death 1 antibodies have been used as downstaging procedure. Although proper selection of patients is a pre-requisite for salvage related liver failure.
Core Tip: The primary treatment modality for advanced hepatocellular carcinoma is systemic therapy. However, downstaging can be done with use of locoregional modalities like trans arterial chemoembolization, transarterial radioembolization, radiation therapy etc. along with systemic therapies (tyrosine kinase inhibitors and immune checkpoint inhibitor) followed by salvage surgery results in improved survival with limited adverse effects, if patient selection is judiciously made.
