关键词: 肝细胞癌, 新辅助治疗, 系统治疗, 免疫治疗

Abstract: Application progress of systemic therapy in neoadjuvant therapy before operation of liver cancer        ZHANG Zi-jie, QIAO Zi-yun, FENG Hao, et al. Department of Liver Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University; Research Center of Organ Transplantation and Immunology, Shanghai Jiao Tong University, Shanghai 200127, China
Corresponding author：FENG Hao，E-mail:surgeonfeng@live.com
Abstract    In recent years，systemic therapy for hepatocellular carcinoma（HCC）has progressed rapidly. New immune-checkpoint inhibitors and molecular targeted drugs have been emerging，and new treatment concepts and treatment schemes continue to innovate. However，there are relatively few discussions on the choice of systemic treatment for HCC before surgery and its efficacy. Neoadjuvant systemic therapy for HCC can be divided into neoadjuvant systemic therapy for resectable HCC，conversion therapy for unresectable HCC and down-staging or bridging therapy before liver transplantation according to its purpose and subsequent surgical procedures. The neoadjuvant systemic therapy should be based on preoperative diagnosis，especially pathological diagnosis，multidisciplinary team（MDT）and molecular tumor board（MTB）discussion，efficacy evaluation，endpoint selection and whole process management during and after operation. Since liver transplantation for HCC involves systemic immune regulation and immune microenvironment remodeling，the comprehensive treatment options and methods are still in the stage of discussion. The use of neoadjuvant therapy for preoperative downstage or preoperative bridging of liver transplantation for liver cancer is an important issue that needs to be discussed in the age of immunotherapy.

Key words: hepatocellular carcinoma, neoadjuvant therapy, systemic therapy, immune therapy