Editor's Note: From September 25 to 29, 2024, the 27th National Clinical Oncology Conference and the 2024 CSCO Annual Academic Meeting, co-organized by the Chinese Society of Clinical Oncology (CSCO) and the Beijing Xisike Clinical Oncology Research Foundation, was held in Xiamen. The conference, themed "Patient-Centered, Future Shared," brought together the latest developments and future trends in cancer prevention and treatment. At the conference, Oncology Frontier had the honor of interviewing Dr. Feng Shen, Chairman of the CSCO Hepatocellular Carcinoma Expert Committee and the designated Chairman of the CSCO Biliary Tumor Expert Committee, from the Third Affiliated Hospital of Naval Medical University(Eastern Hepatobiliary Surgery Hospital) to share his experience with CSCO, insights on the development of the CSCO Hepatocellular Carcinoma Expert Committee, and explore the current status and challenges of personalized surgical treatment for hepatobiliary tumors. Prof. Shen also discussed the key factors and insights behind promoting personalized surgical development based on clinical predictions.Growing Together with CSCO
Witnessing the Glorious Growth of CSCO and Contributing to the Development of the Hepatocellular Carcinoma Expert Committee
Dr. Feng Shen: My mentor, Academician Wu Mengchao, was one of the founders of CSCO, so I became connected with CSCO from its inception and joined it early on. At that time, I would accompany Academician Wu to participate in most of CSCO’s academic activities. Over the years, I have witnessed the growth and expansion of CSCO. In its early days, there were fewer oncological surgeons within CSCO, and the organization was not as large as it is today. Time flies, and with the relentless efforts of several generations of oncology scholars, we have seen CSCO evolve into a comprehensive and multidisciplinary academic organization leading clinical oncology in China. Today, CSCO is gaining increasing academic influence in the international arena, which is a remarkable achievement.
I feel extremely honored to serve as the Chairman of the CSCO Hepatocellular Carcinoma Expert Committee. With the strong support and guidance of academicians and experts like Wu Mengchao, Qin Shukui, and Fan Jia, the committee has developed rapidly. First, the committee has grown from being primarily composed of oncology specialists to becoming a comprehensive group covering multiple disciplines. Second, the committee has become an important academic organization in the field of liver cancer in China. Third, the annual CSCO Primary Liver Cancer Diagnosis and Treatment Guidelines introduced by the committee have been well-received due to their high accessibility, timeliness, and practicality, providing guidance for clinical practice. Additionally, the committee has carried out a series of academic activities, establishing an efficient platform for academic exchange.
In conclusion, members of the CSCO Hepatocellular Carcinoma Expert Committee are united in their common goal. The progress we have made is the result of collective effort. I believe that under the leadership of CSCO and with the concerted efforts of experts and scholars, we will continue to move forward and make new contributions to liver cancer diagnosis and treatment in China.
Current Status and Challenges of Personalized Surgical Treatment for Hepatobiliary Tumors
Relentlessly Pursuing Personalized Treatment and Exploring MVI to Guide Clinical Decisions
Dr. Feng Shen: Personalized treatment of hepatobiliary tumors is our continuous pursuit. However, there are still major challenges in practice. Currently, surgical decision-making relies more on clinical experience and the physician’s understanding, with a lack of biomarkers reflecting tumor characteristics to serve as a “grip” for guiding personalized treatment. There is a saying in oncological surgery: “Biology is King, Selection is Queen.” However, “Biology” is still an area requiring further clinical exploration. Researchers are conducting studies in various omics fields, which may provide solutions to this issue.
For patients with unresectable advanced liver cancer, we can already choose targeted or immunotherapy strategies, and the development of personalized treatment is relatively mature in this regard. However, for early and intermediate-stage liver cancer, there is still a need for research to improve the level of personalized treatment. Our team has been exploring the use of microvascular invasion (MVI) to guide individualized treatment decisions. MVI reflects the invasive characteristics of liver cancer. By assessing the risk of MVI before treatment, we can accurately select the most effective and safest treatment plan for the patient, including decisions among major therapies such as resection, ablation, or transplantation, as well as choices among different technical methods within a specific treatment. For example, predicting MVI for liver resection can guide choices regarding different surgical techniques, margins, and the need for neoadjuvant therapy, aiming to resolve some of the existing controversies in liver cancer treatment. In short, the exploration of MVI has begun, and more in-depth studies on other biomarkers beneficial to treatment decisions are urgently needed.
Clinical Prediction Drives Advances in Personalized Surgical Treatment for Hepatobiliary Tumors
Guiding Treatment Decisions Through Prediction and Expanding Prediction Throughout the Entire Process
Dr. Feng Shen: For physicians, “treating patients” mainly involves three steps: diagnosis, treatment selection and decision-making, and clinical implementation. Accurate treatment decisions are based on precise prognostic predictions. Clinically, different types and stages of tumors may have multiple treatment options. Predicting the prognosis of different treatments is crucial for decision-making.
Of course, there is much room for improvement in clinical prediction. On the one hand, physicians need to improve their clinical prediction capabilities to make personalized predictions based on the disease characteristics of each patient. For groups of patients with similar characteristics, these characteristics need to be summarized to build predictive models, thoroughly validated, and then used to perform individualized predictions. This enhances the scientific, accurate, reproducible, and universal nature of clinical predictions. On the other hand, clinical predictions for liver cancer surgery must cover the entire course of diagnosis and treatment. Prediction must continue throughout the entire process, including early diagnosis, disease staging, surgical prognosis, surgical complications, postoperative recurrence prevention, and subsequent treatment. Only then can we provide more suitable treatment strategies for patients and achieve better therapeutic outcomes. This was the core content of my presentation at this CSCO conference—improving the clinical practice of liver cancer diagnosis and treatment through continuous, whole-process clinical predictions.
Dr. Feng Shen
• Chief Physician, Professor, Doctoral Supervisor, and Major General of Professional Technology
• Shanghai Oriental Hepatobiliary Surgery Hospital, Third Affiliated Hospital of Naval Medical University
• Nearly 40 years of experience in hepatobiliary surgery, specializing in multidisciplinary and surgical treatment of liver cancer and intrahepatic cholangiocarcinoma
• Recipient of over 20 scientific and technological awards, including the Second Prize of the National Science and Technology Progress Award as the first recipient and two First Prizes of the Shanghai Science and Technology Progress Award
• Recipient of the Ho Leung Ho Lee Foundation Science and Technology Progress Award
• Published over 150 SCI papers as a corresponding author
• Editor-in-Chief of Hepatocellular Carcinoma and Deputy Editor of the 8th Edition and Co-Chief Editor of the 9th Edition of Huang Jiasi Surgery
• Vice-Chairman of the International Hepato-Pancreato-Biliary Association (IHPBA), Secretary-General of the Asia-Pacific Hepato-Pancreato-Biliary Association (A-PHPBA), Vice-Chairman of the Asia-Pacific Hepatic Surgery Development Committee (APHAB) Presidium, Vice-Chairman of the National Health Commission’s Expert Committee on Liver Cancer Diagnosis and Treatment Guidelines, Chairman of the CSCO Hepatocellular Carcinoma Expert Committee, Designated Chairman of the CSCO Biliary Tumor Expert Committee, Vice-Group Leader of the Hepatic Surgery Group of the Chinese Medical Association Surgery Branch, and Chairman of the PLA Hepatobiliary Surgery Specialty Committee.
