16肝胆外科杂志2023年2月第31卷第1期Journal of Hepatobiliary Surgery,Vol,31.No.1,Feh.202318 Giannis D,Sideris G,Kakos CD,et al.The role of liver transplan-Bureau,Division of Transplantation,Rockville,MD;United Net-tation for colorectal liver metastases:A systematic review and pooledwork for Organ Sharing.Richmond,VA.http://optn.transplant.hr-analysis.Transplant Rev (Orlando),2020,34:100570.sa.gov/data/view -data-reports/national-data.19 Smedman TM,Line PD,Hagness M,et al.Liver transplantation for23 Cameron AM.Just How Low a Model for End-stage Liver Diseaseunresectable colorectal liver metastases in patients and donors with ex-Score Benefits From Living-Donor Liver Transplant?JAMA Surg.tended criteria SECA-II arm D study )BJS Open.2020.4:4672022.157(10).933.477.24 Sparrelid E.Johansson H.Gilg S.et al.Serial assessment of growth20 Line PD,Hagness M,Berstad AE,et al.A novel concept for partialfactors associated with liver regeneration in patients operated with as-liver transplantation in nonresectable colorectal liver metastases:thesociating liver partition and portal vein ligation for staged hepatecto-RAPID concept.Ann Surg,2015,262:e5 -e.my.Eur Surg Res.2018,59:72-82.21 Tran,Lillian,Humar,Abhinav.Current status of adult liver trans-25 Herandez-Alejandro R,Ruffolo LI,Sasaki K,et al.Recipient andplantation:utilization of living donor versus deceased donor graft.Donor Outcomes After Living-Donor Liver Transplant for UnresectableCurrent Opinion in Organ Transplantation,2021,26(2),133-138Coloreetal Liver Metastases.JAMA Surg.2022.157(6):524 -530.22 Organ Procurement and Transplantation Network.National Data:26 S.Nadalina,U.Settmacherb,F.Rauchfub,et al.RAPID procedureTransplant by Donor Type.Annual Report of the U.S.Organ Pro-for coloreetal cancer liver metastasis.Int J Surg.(2020).curement and Transplantation Network and the Scientific Registry of(本文编辑歌小平)】Transplant Recipients.Department of Health and Human Serves,Health Resources and Services Administration,Healtheare Systems肝细胞癌转化治疗临床策略与指南解读程远，徐子令，荚卫东【关键词】肝癌：转化治疗【中图分类号】R735.7【文献标识码】C【文章编号】10064761(2023)01001604在我国恶性肿瘤的发病率及致死率排行中，原高手术切除后的疗效？-。肝癌转化治疗的内涵发性肝癌均位居前列（发病率第4位和致死率第2即为通过减少肿瘤负荷或使肿瘤降期，以提高O位)，严重危害人民生命健康2)。肝细胞癌(hepd切除成功率、增加患者术后的生存获益tocellular carcinoma,HCC,以下简称肝癌)是原发性手术为主的综合治疗是中晚期肝癌患者可能行肝癌中最常见的病理类型，约占75%~85%)。由根治性切除和改善预后的主要策略，国家卫生健康于肝癌起病隐匿且在早期缺乏特异性临床表现，导委员会《原发性肝癌诊疗规范(2019版)》和《原发致半数以上肝癌患者确诊时已为中晚期，丧失根治性肝癌诊疗指南(2022版)》均推荐转化治疗作为中性手术切除的机会，造成患者较差的生命质量和远晚期肝癌综合治疗新策略的重要起始环节2，)。期生存预后（中位生存时间通常低于1年）4-6为进一步推动肝癌转化治疗的临床实践与研究，我随着系统性药物治疗和非手术局部治疗在肝癌国相关领域专家制订了《肝癌转化治疗中国专家共领域的应用与发展，部分中晚期或不可切除肝癌可识(2021版)》114。本文将围绕上述指南与共识，实现较好的客观缓解率(objective response rate,侧重于系统治疗和非手术局部治疗等手段在肝癌转ORR)或肿瘤降期，继而获得根治性切除机会并提化治疗中的作用，并结合最新研究进展，就肝癌转化治疗的人群和原则、策略选择进行阐述与解读。【基金项目】2021年安激省重点研究与开发计划项目(20210407)【作者单位】中国科学技术大学附属第一医院肝脏外科，合肥1肝癌转化治疗的人群和原则230001肝癌转化治疗的定义是将“不可切除肝癌”转【通讯作者】英卫东化为“可切除肝癌”，阶段性目标为切除肿瘤，最终
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