Editor’s Note: The 9th Congress of the Chinese Chapter of the International Hepato-Pancreato-Biliary Association (CCIHPBA)” was held in Wuhan from October 25-27, 2024, drawing renowned experts from over 20 countries, including the United States, Germany, France, Russia, and Australia. With more than 50 prominent international scholars, 21 academicians, and over 700 experts in liver, gallbladder, and pancreas oncology, the symposium provided a platform to discuss the latest advancements and standards in liver cancer diagnosis and treatment. Dr. Tianqiang Song from Tianjin Medical University Cancer Institute and Hospital delivered an insightful presentation on “Advancements in Perioperative Treatments for Liver Cancer and the Tianjin Experience.” In a joint interview with Oncology Frontier, Professor Song shared insights into perioperative treatment research and practical experiences.

Oncology Frontier: In this congress , you presented on “Advancements in Perioperative Treatments for Liver Cancer and the Tianjin Experience.” Could you summarize the key points for our readers?

Prof. Kuansheng Ma: The core of my presentation focused on the role and impact of systemic treatment throughout the liver cancer treatment journey, especially in the perioperative period. For liver cancer patients with high postoperative recurrence risks, systemic therapies such as targeted and immunotherapy, along with local therapies, serve as adjuvant treatments to address residual microscopic lesions, ultimately improving the 5-year survival rate. Additionally, for some patients initially deemed inoperable, systemic and local therapies as neoadjuvant approaches may reduce tumor size and numbers, creating potential opportunities for surgery.

Oncology Frontier： How does the 2024 edition of the Primary Liver Cancer Diagnosis and Treatment Guidelines differ from other liver cancer guidelines in China? How does it compare to recommendations in other regions like Europe and the United States?

Prof. Kuansheng Ma: The Primary Liver Cancer Diagnosis and Treatment Guidelines (2024 Edition) emphasize a unique Chinese perspective. Liver cancer ranks as the fourth most common cancer and the second leading cause of cancer-related deaths in China. Approximately 45% of new liver cancer cases globally each year are from China, with 80-90% caused by hepatitis B. In contrast, liver cancer incidence in Western countries is lower, often related to alcohol-related liver disease or hepatitis C, highlighting a distinct etiological difference. Unfortunately, in China, about 70% of liver cancer patients are diagnosed at mid-to-late stages when surgery is no longer an option, compared to early-stage detection in Western countries. Thus, Chinese guidelines and hepatology experts prioritize strategies to convert inoperable patients to operable ones. The 2024 guidelines place increased emphasis on systemic and local therapies as transformation treatment strategies.

Oncology Frontier：What is your perspective on the current clinical value of the systemic treatments recommended in the 2024 guidelines?

Prof. Kuansheng Ma: The treatments recommended in the 2024 Primary Liver Cancer Guidelines serve three main purposes: first, to treat patients with inoperable mid-to-late-stage liver cancer, converting some to operable status; second, as neoadjuvant treatments to lower postoperative recurrence risk in high-risk patients; and finally, to reduce recurrence risk in postoperative patients when combined with local therapies. In sum, these guidelines support comprehensive liver cancer treatment across all stages.

Oncology Frontier： The guidelines also mention the possibility of combining systemic therapy with TACE/HAIC, along with recent clinical progress in this area. How do you view the future of this treatment approach?

Prof. Kuansheng Ma: Clinical studies indicate that using systemic treatment alone for mid-to-late-stage liver cancer achieves an objective response rate of about 40% at best, such as with targeted and immune combination therapies. However, combining this with local therapies like TACE/HAIC or radiotherapy can increase the objective response rate to 60%-70%, suggesting it may become a primary model for conversion therapy in inoperable liver cancer cases.

Prof. Kuansheng Ma

• Southwest Hospital, Chongqing
• Director, Department of Hepatobiliary Surgery, The Southwest Hospital of Army Medical University
• Professor, Chief Physician, Doctoral Supervisor
• Visiting Scholar, University of Tokyo; Chongqing Talents Program – Distinguished Expert
• Executive Committee Member, Hepatic Surgery Committee, Chinese Medical Doctor Association
• Executive Committee Member, Tumor Ablation Committee, Chinese Medical Doctor Association
• Executive Committee Member, Liver Cancer Committee, Chinese Anti-Cancer Association
• Member, Hepatic Surgery Group, Surgery Branch, Chinese Medical Association