With the publication of a vast amount of clinical research on hepatocellular carcinoma (HCC), the American Association for the Study of Liver Diseases (AASLD), the National Comprehensive Cancer Network (NCCN), the American Society of Clinical Oncology (ASCO), and the National Health Commission of China have all updated their diagnostic and treatment guidelines for HCC. There are no differences in the definition of HCC risk populations among the AASLD 2023, NCCN 2024, and China Liver Cancer Staging and Treatment Guideline (CNLC) 2024. Notably, CNLC 2024 has updated its guidance on high-risk factors and prospective surveillance for HCC based on the characteristics of HCC patients in China. The four guidelines have seen significant updates in the areas of neoadjuvant and adjuvant therapies, local treatments, and systemic treatments for HCC. CNLC 2024 refines the indications for local treatment, improves systemic treatment, and introduces new first-line therapy, including camrelizumab combined with rivoceranib or tislelizumab. The second-line therapy nivolumab plus ipilimumab for advanced HCC are recommended by AASLD 2023, NCCN 2024, and ASCO 2024, which may become a new first-line therapeutic option for patients with advanced HCC. We compare and interpret these four guidelines in this paper.
ObjectiveTo explore the feasibility of laparoscopic hepatectomy of malignant liver tumors under the day surgery management model based on the concept of enhanced recovery after surgery (ERAS). MethodsThree patients who underwent laparoscopic resection of malignant liver tumors under day surgery model in the Department of Hepatobiliary Surgery of the First Affiliated Hospital of Guangxi Medical University from June to November 2022 were retrospectively collected. The clinical application effects of this model were comprehensively evaluated. ResultsAll 3 patients (cases 1–3) successfully completed complete laparoscopic partial liver resection, with operation time of 155, 183, and 201 min, respectively, as well as intraoperative blood loss of 20, 100, and 50 mL, respectively. Postoperative pathology confirmed that cases 1 and 2 were hepatocellular carcinoma, and case 3 was rectal adenocarcinoma with liver metastasis, and the resection margins all met the R0 standard. All patients resumed oral feeding at 6 h after surgery and were able to get out of bed at 8 h after surgery. All 3 patients were discharged within 24 h after surgery. The hospitalization cost of the three patients was (22 602.0±3 400.0) yuan. All patients were followed up for more than 24 months and maintained a tumor-free survival state, without tumor recurrence and metastasis. ConclusionThe results of this limited cases suggest that laparoscopic liver resection under day surgery model is initially feasible and safe for strictly selected patients with liver malignancies combined with a standardized ERAS management pathway.